revision SCORE - Amplitude ortho
Contents
1. Preparation phase e Select the image of SCORES You arrive at the opening page Revision surrounded by blue To access the first screen press the blue arrow Information Page Patient information stage Use the keyboard to type the information on the tactile screen Surgeon s name e Patients name Patient s date of birth not obligatory e Side to be operated press the button corresponding to the operated side he t To go to the following stage blue arrow on the screen by using the blue pedal or by pressing o return to the preceding stage validate by using the yellow pedal or by pressing the yellow arrow on the screen AMPLITUDES Clip button Limit between rigid part Jig and support Patella Fixing pins Fixing Support Femur Jig Femur Fixing pins Jig Tibia Markers 8 Installation of jigs Clip the spherical markers on the jigs for the T tibia e for the F femur 4 for the P probe pointer e for the G guide he fixing pins should be placed in internal antero on the femur and the tibia and should not get in the way of the screw tap installation They can either be installed firstly through the cut or under the skin Install the first pin go across the 1st cortical and fix it in the 274 cortical without going across it Put the system of fixat the second pin ion of jigs on this pin so as to ob2. 7 2 Blue return a Femoral runner 2 ss Blue 7 tightening screw Posterior fork C1 9 bou Yellow tightening Screw 8 Fellow femoral viewfinder 66 Navigated instruments Prober pointer e This intrument is used to define precise points or surfaces on the patient s anatomy It is also used to give commands to certain active elements on the screen The probe pointer should be equipped with four markers one of which is set up on the movable trigger Fixed jig Movable marker on the trigger The universal handle and the monoblock tibial palette for tibial cuttin acquisition he navigated universal handle and the monoblock tibial palette have two fixation points for the guiding jig one on each side Monoblock tibial palette Navigated universal handle 6 SCORES Revision Saw blades SYNTHES AO SODEM troite e STRYKER 2000 troite 3M Maxi Driver troite STRYKER B troite AESCUL AP troite ZIMMER HALL troite 68
3. Ld AMPLITUDE HIP CENTER Proceed to the hip centre acquisition AMPLITUDE HIP CENTER Acquisition of the center of the hip Acquisition of the center of the hip With the leg extended take hold of the patient s heel Press the blue arrow or the blue pedal to begin the acquisition of points Carry out a circular movement with the leg of a radius of 15 cm around the knee e Once the acquisition is completed the system calculates the center of the hip If the result is satisfactory the system proceeds automatically to the following stage Otherwise the system requests that the acquisition be recommenced During this stage a beeping sound indicates the beginning of the acquisition cursor simulating the acquisition appears at the bottom of the screen and a beeping sound indicates the end of the acquisition 17 AMPLITUDE The inter glenoids axis will define a frontal plane for the Tibia Palpate The inter glenoids axis will define a frontal plane for the Tibia Palpate a point on the medial glenoid a point on the lateral glenoid 36 18 Tibial acquisitions Centre of the tibia Palpate the centre of the tibial plateau e Validate the position by pressing the trigger Medial articular surface The frontal plane of the tibia will be chosen by the surgeon and drawn by electric scalpel on the tibial plateau in the middle of the articular surfaces Palp
4. ie p 54 Trial implants and data recording Extension test Place a trial insert Place the leg in extension Visualise the HKA angle and the spaces medial and lateral with the trial components in place Valide the position 99 HKA 170 VAR 10 FLEXION 90 Set the leg in the desired position and then press the blue footswitch to take a snapshot e AMPLITUDE 96 Trial implants Flexion test Place the leg in flexion Visualise the spaces in flexion with the trial components in place Validate in the desired position by pressing the blue pedal to record the desired position in the operating report Other positions with different degrees of flexions can be recorded using the blue arrow 57 Recording the surgical report Record the surgical report Press the red button to leave the application lower right of screen Validate your intention to leave the application Validate your intention to save the surgical report e Save the surgical report by inserting the USB key in the connection situated under the screen see station description and confirm save surgical report is a file called report html which follows the chronology of the procedure and includes these pages patient information and name of the surgeon e the result of bone deformities e programming pages of bone cuts programming pages of position and siz
5. Remove the viewfinder and the screw tap e Place the femoral cut guide of the appropriate size on the 2 pins e Attach it using nails and anterior stabiliser Make the cuts Navigation of the pre cut when the femoral distal cut is greater than 10 mm After installing the pins use the distal femoral reamer as indicated on the screen to make the scheduled pre cut Place the reamer on the pin in contact with the condyle e Adjust the stop to the value of the cut at 4 mm if the pre cut is 4 mm using graduations 2mm by 2mm Perform the distal pre cut Remove the viewfinder and the screw tap o Perform the cuts 47 AMPLITUDE AMPLITUDE 35 mm Lat bi 1mm Med 48 Trochlear groove preparation Centring du quide de pr paration d chancrure Install the trochlear groove preparation guide Place the point of the probe pointer on the anterior cone of the guide The medio lateral distance could be appreciated between the planned position and the real position of the trial condyle When the desired position is obtained fixe the guide with 2 headed pins and prepare the trochlear groove 49 AMPLITUDE AMPLITUDE Place the trial implant in medio lateral using the tracker Then palpate the FIRST calibration cone OGD Palpate the THIRD calibration cone 0950 50 Trial implants Acquisition of the final position Place the point of the
6. probe pointer in each of the 3 cones and validate each position by pressing with the trigger Validate each position 51 SIZE B ANT POST Omm FLEX JRECURV 4 Flex ROTATION 0 DISTAL CUT 9 mm MED LAT VAR J VAL 1 Val Realized values white compared to the planified ones green 1mm Med 3l VAR VAL 2 Var MED LAT 4 mm Lat HEIGHT 10 mm SLOPE T Ant ANT POST 4 mm Ant ROTATION 3 Int AMPLITUDE Trial implants Finale position of the trial femoral condyle The trial implant in grey is superposed in the position of the scheduled implant in green The size and final position of the implant appear in white and the scheduling in green Final position of the trial tibial embase Install the handle with the jig G on the trial tibial embassy of the estimated size Place the trial embassy on the cut and visualise its position in medio lateral and antero posterior position in relation to that scheduled In white the navigated values in green the scheduled values Fix the position of the embassy with 2 headed pins Validate the position of the embassy EITHER by validating with the jig G mounted on the handle OR by acquiring the 3 calibration cones with the probe pointer 53 HKA 180 VAR 0 FLEXION Set the leg in the desired position and then press the blue footswitch to take a snapshot
7. then use the keys or to modify the values Press the O key to return to the schedule proposed by default e Validate the schedule 39 36 Tibial cut Calibration of tibial viewfinder Install the screw tap Fix the jig G on the tibial viewfinder Install the viewfinder on the screw tap Place the point of the probe pointer in each of the 3 cones situated on the tibial viewfinder and validate each position with the trigger A green cone guaranties the accurate acquisition The order in which this operation is carried out is not important 3 ROTATION G LI AMPLITUDE ORT GHNE Ant E BE VATS VAL HEIGHT P Var O 10 mm 40mm INSERT THE PINS VALIDATE AND CUT Q o 00 SLOPE ey zie 1 Post 0 LG W AMPLITUDE Lat Ant 10 mm 10 mm Acquire the performed cut 38 Tibial guiding Navigation of the tibial cut The screen represents the different planes to be navigated the viewfinder part to be used is identified by a colour code The scheduled value appears in green on the screen The navigated value appears in white if the viewfinder is not aligned correctly It appears in green when the scheduled target is reached with a precision of 1 or 1 mm When the viewfinder is in the right position the value and the pal of cut appear in green Place th
8. viewfinder on the screw tap Place the point of the probe pointer in each of the 3 cones situated on the femoral viewfinder and validate each position with the blue pedal A green cone guaranties the accurate position The order in which this operation is carried out is not important 45 VARIVA FLEX RECURV 13 Val MEN 1 Flex 0 AMPLITUDE FLEXION 76 HKA 171 9 Var SIZE CASE Lat Med A FLEX RECURV 0 ROTATION Ext 3 Tr Distal Resection vm wm at d L A 12 M 11 mm A MED LAT VAR JVAL 0 Adjust the position of the implant by changing the parameters PLITUDE Omm 0 mm 1 E 5 Lat 1mm Proceed to the reaming of the distal pre cut LI ums oe o 46 Femoral guiding Navigation of the femoral cut e The screen represents the different planes to be navigated and the part of the viewfinder to be used can be identified by a colour code e The scheduled value appears in green on the screen e navigated value appears in white when the viewfinder is not correctly aligned It appears in green when the scheduled objective is achieved with a precision of 2 or 2 e When the viewfinder is correctly aligned the value and the cutting plane appear green Install the pins when all the navigated correspond to the scheduled values e Validate the position by pressing on the blue pedal
9. Navigated Surgical Technique SCORE Revision Total Knee Prosthesis TO G GB 007 1 0 Preparation phase Locked position Locking handle Unlocked position Preparation phase Position the station in relation to the patient Reminder minimum distance 1 5 m Regulate the optical head in neutral position at maximum height and without rotation Unlock the mobile column lift the locking handle and let the column rise freely to high position Press the green stop go button at the back of the station Button in position ocreen description Dynamic navigation zone HKA 181 VAL 1 FLEXION 0 Um mm Em A Visibility and positioning of rigid structures Permanent buttons F Femur Tibia Probe 5 Guide Description of permanent buttons Validate and ga to following stage Calibrate probe pointer with Return to preceding stage relation to the screen SCREEN CALIBRATION m Operating time Photo af active Off button screen Appears when probe pointer cannot be used for screen selections SURGEON AMPLIVISION PATIENT SITE DUPONT Forenamc Day Month ni Year DATE OF BIRTH DD MM Y Y Y Y o Ne NN i 1 i LLL OPERATED SIDE LEFT RIGHT LE LS ELS EN CS ES ESL EL L0 JOHN re SIS T TS TT DHT AI EI KA CIGI EN Type in the fields through the virtual keyboard Select the operated side INFORMATIONS 2
10. ate a point in the middle of the medial articular surface on the axis already traced Validate the position by pressing the trigger Lateral articular surface Palpate a point in the middle of the lateral articular surface on the axis already traced Validate the position by pressing the trigger 19 Points 0 1 AMPLITUDES Points AMPLITUDE Distance Med mm Distance Digitize the tibial surface and check the result 20 cquisition of the tibial anatomic relief Tibial acquisitions The objective of this stage is to acquire the bone surface of the tibia and to test the precision of this acquisition Place the point of the probe pointer on the bone surface press and hold down the trigger and move the point over the articular surface to be acquired It is preferable to carefully draw the contour of the tibial plateau size of future implant and to take points in the zone where the tibial cut will be carried out Attention always leave the point of the probe pointer in contact with the tibial surface When you press the trigger of the probe pointer the acquisitions begin and removing pressure from the trigger puts an end to the current acquisition A bip sound starts and ends the acquisition surface procedure When the 3 interest zones indicated by red cubes anterior medial and lateral turn green this means that the minimum quantity of points for these zones has
11. been obtained Control green lines to the right of the screen are in the contact of the bone During the acquisition of points the articular surface is distorted in real time Interest zones e They are represented by fixed red lines and cubes at the beginning of the acquisition then green and moving during the acquisition e They are 3 of them medial anterior lateral e They represent the minimal zones of reference to determine the size and to position the embase 21 Points AMPLITUDE Distance Digitize the tibial surface and check the result ACQUIRING TIBIAL DATA 22 Tibial acquisitions Verification of global acquisition Take the pressure off the trigger and move the point over the articular surface The system calculates the distance between the point of the probe pointer and the 3D model Move the probe pointer over the bone The probe pointer appears in green when the distance between the model and the reality is less than a millimetre and in red when the distance is more than a millimetre In the event of incorrect acquisition It is possible to cancel the latest 20 points acquired by pressing the yellow pedal A prolonged press more than 2 seconds cancels the totality of acquired points If the precision of the distorsion is satisfactory validate so as to pass on to the next stage 23 MPLITUDE Palpate the apex of the groove Palpate the most posterior point on the medial c
12. e of implants page of post operative validation e Remark if you do not wish to save the surgical report press cancel when the AMPLIVISION system offers to save the surgical report 58 otoring the station When you leave the program the first page appears Press the leave program button Validate closing the system Wait for the message giving permission to close the station Press the green sop go button situated at the back of the station Button in position 0 Unplug the power cord and wind it around its rack situated behind the station Disconnect the pedal Adjust the optical head in neutral position maximum height without rotation Clean the station and the pedal see user s manual situated in the carrying case Lock the movable column lower the locking handle and pull it vigorously downwards to bring the column down completely Replace the station in the carrying case Place the pedal and the protective covers in the carrying case Lock the 4 locking points of the carrying case 99 SCORES Revision Total knee prosthesis Navigated Instrumentation 60 Complementary information e Complementary to navigated mecanical PTG SCORE Revision it is indispensable to have AMPLIVISION navigation station Amplitude SCORE Revision integrated software Sterile single use markers box of 14 AMPLIVISION navigated version instrumentation Sterile Markers oingle use ste
13. e pins when all the navigated values correspond to the scheduled values Validate the position blue pedal probe pointer or directly on the screen Remove the screw tap and the viewfinder place the tibial cut guide on the pins Make the tibial cut Acquisition of the plan of the cut e monoblock tibial palette install the jig G Position the monoblock tibial palette on the tibial cut already made and validate 39 FLEXION 0 A 180 0 Var Med ANT POST g half wedge of FLEX RECURV 0 2 4 or 6mm Posterior resection ROTATION 0 A DISTAL CUT 10 0 mm TT la 9p _ mobile disc VAR IVAL ann ae Adjustable spacer 10 2 mm 10 2 mm Adjust the position of the implant by changing the parameters E Complete wedge of 2 or Adjustable spacer 4 mm FLEXION 76 HKA 171 9 Var Med Lat SIZE ANT POST FLEX RECURYV RON eg d mne Posterior resection DISTAL CUT 10 0 Mmm d MED LAT 0 mm 1043 mm Im TARTAN Adjust the position of the implant by changing the parameters E MPLITUDE Q FEMUR ELANNNG 2 Www 40 Extended xtension the adjustable spacer fills the space between the tibial cut and the non MM femur The adjustable spacer is provided with 2 mobile discs adjustable by micrometric screw which can fill the space on the side desired after addition if necessary of a mobile hal
14. er repeat the same operation while slightly changing the direction of the probe pointer and validate Tibia confidence point e Place the point of the probe pointer in the calibration cone which can be found on the support of jig T and validate e definitive position of jig T on its fixation support can be validated by this manipulation Throughout the procedure it is possible to check if this position has been modified Femur confidence point e out the same manipulation with the support of jig F At any time during the surgical procedure you can put the point of the probe pointer in the tibia and or femur confidence point In the lower left hand corner of the screen the message Tibia OK and or Femur OK appears if the jig has not moved If it is not the case depending on the operative stage reached either you continue the procedure in the normal way or you return to this calibration stage 13 AMPLITUDE AMPL AMPLITUDE DE Acquisition of the center of the ankle Medial malleolus Place the point of the probe pointer on the most distal point of the medial malleolus Validate the position by pressing the trigger of the probe pointer Lateral malleolus Place the point of the probe pointer on the most distal point of the lateral malleolus Validate the position by pressing the trigger of the probe pointer 15 Proceed to the hip centre acquisition
15. f wedge of 2 4 or 6 mm until the desired HKA angle appears on the screen If necessary complete wedges of 2 or 4 mm can be added under the spacer tibial cut side Once the HKA angle has been adjusted the surgeon can test visualise and adjust the ligamentary balance by a ligamentary release and or by modifying the position of the virtual femoral implant by using the navigator s tactile screen NB The areas shown on the screen are those between the tibial cut already made and the virtual femoral prosthesis whose position is known to the computer Flexed When the balance in extension is completed flex the knee at 90 Using the spacer adjusted for saturation equivalent to the height of the insert installed in the preceding step value read on the screen between the tibial cut and the virtual femoral implant in extension check the flexed areas as well as the ligamentary balance The surgeon can simulate the external rotation of the virtual femoral implant to T i the 2 areas T ad screen Vir unb the and the Choice of a femoral distal cut of more than 8 mm A black line represents the contact zone between the internal distal surface of the femoral component and the distal cut The thickness of the cut on the two condyles is visible Increase the thickness of the femoral distal cut using the tactile screen from 2mm to 2mm in case of istant or insufficient of one of the two c
16. he bone The probe pointer appears in green when the distance between the model and the reality is less than a millimetre and in red when the distance is more than a millimetre It is possible to obliterate the last 20 points acquired by pressing the Yellow pedal Holding the trigger down more than 2 seconds obliterates all the acquired points If the precison of the distorsion is satisfactory validate and go on to the next stage If the acquisition has been incorrect It is possible to obliterate the last 20 points acquired by pressing the Yellow pedal Keeping the pedal down more than 2 seconds obliterates all the points acquired If the precision of the distorsion is satisfactory validate and go on to the next stage Acquisition of the pre operative HKA angle Freely extend the leg Visualise the pre operative HKA angle Validate and go on to the next stage 31 P T AMPLITUDE Lat Ant Height of cut 10 mm Palpate the reference point for the height of cut If needed adjust the height of cut 9 GEISID 32 Tibial planning Reference point Adjust the height of cut indicated in the corner down to the right of the screen by using the or keys of the tactile screen Palpate the point which will serve as reference for the height of the cut Between this point and the red line the cut level there will the thickness planned For exam
17. ite infrared sources sunlight hot lights IMPORTANT At all times during the surgical procedure you can adjust the position of the cameras e Select the visibility square of the jigs lower left Adjust the position of the localisator Re select the visibility square of the jigs to return to the initial operating time Screen calibration Point the probe pointer in the direction of the center of the AMPLIVISION screen and validate by pressing the trigger From this stage on it is possible to pilot AMPLIVISIONS either with the probe pointer by pressing the trigger to validate with the pedal with the tactile screen of the station AMPLIVISION The system records screen images when the user validate a stage with the blue pedal the user presses the icon representing a camera at the lower right hand corner of the Screen 11 AMPLITUDE Put the tracker tip in the cone on the fixing support of the jig Tibia and Put the tracker tip in the cone on the fixing support of the jig validate and validate DAOU DE AMPLITUDE REED OO 0 ED 0 calibration probe pointer and jig Calibration of probe pointer This stage is divided into two parts e Tocalibrate the point of the probe pointer place the end in the calibration cone situated on jig T and validate by pressing the trigger e Without lifting the point of the probe point
18. me e t is preferable to carefully draw the contour of the femur e At any time it is possible to release the trigger position the point of the probe pointer elsewhere and continue the acquisition by pressing the trigger again Attention Always leave the point of the probe pointer in contact with the femoral surface The acquisitions are begun by pressing the trigger or the blue pedal releasing the trigger ends the acquisitions bip sound starts and ends the acquisition surface procedure When the 7 interest zones indicated by red cubes anterior medial distal lateral distal medial posterior lateral posterior medial and lateral turn green this means that the minimum quantity of points for these zones has been obtained Control green lines to the right of the screen are in the contact of the bone During the acquisition of points the articular surface is distorted in real time 29 Points Distance 173 Digitize the femoral surface and check the result AMPLITUDE 177 VAR 3 FLEXION 1 Place the leg in extension and validate the pre operative HKA angle by pressing the blue footswitch N AMPLITUDE PRE OP VALIDATION M Femoral acquisitions Precision verification Release the trigger and move the point over the articular surface The system calculates the distance between the point of the probe and the 3D model e Move the probe pointer over t
19. ondyle FRONTAL PLANE 24 Femoral acquisitions Summit of the notch Palpate the summit of the notch Validate the position by using the trigger Medial posterior condyle The axis of the posterior femoral condyles is defined by the acquisition of a point on the medial and lateral posterior condyle Palpate the most posterior point of the medial condyle e Validate the position by using the trigger 25 Palpate the most posterior point on the lateral condyle AMPLITUDE Palpate a point on the anterior surface AMPLITUDE Femoral acquisitions Lateral posterior condyle Palpate the most posterior of the lateral condyle Validate the position by using the trigger Anterior cortical Palpate a point on the anterior cortical e _ Validate the position by using the trigger 21 p AMPLITUDE Points 189 MPI ITUDI Distance mm Digitize the femoral surface and check the result ACQUIRING FEMUR DATA OG Distance Dist mm 28 Femoral acquisitions Acquisition of the femoral anatomic relief The objective of this stage is to acquire the bone surface of the femur and to verify this acquisition Place the point of the probe pointer on the bone surface press the trigger and hold it down while moving the point over the femoral surface During the acquisition of points the articular surface is distorted in real ti
20. ondyles genu valgum distal cut inexis large pre operative flexum need to go back to the interline 41 FLEXION 76 HKA 172 8 Var Med Lat SIZE ANT IPOST 0 mm FLEX RECURV 0 ROTATION Ext 3 DISTAL CUT 10 0 mm MEDICA DIMM Angle 30 VAR VAL AMPLITUDE FLEXION 76 HKA 172 8 Var Med Lat SIZE ANT POST Omm FLEX RECURV 0 ROTATION Ext 3 DISTAL CUT 10 0 mm g MED EAT Excessive thickness Pu Angle 90 5 Y Kd VAR VAL 0 Id 1mm Adjust the position of the implant by changing the parameters 42 Medio lateral positioning To place the virtual femoral component under the patella part the navigation system can help you e Select the medio lateral key The virtual femoral implant appeared at the bottom of the screen To place the virtual femoral implant in medio lateral side according to the anatomic trochlea in white If on the distal part there is a prothetic surepaisseur the value is indicated These parameteres need to be regulate at 30 60 and 90 of flexion Touch on the picture to change and seemed all views 43 G P AMPLITUDE AMPLITUDES EG AMPLITUDE F SIGHT CALIBRATION 44 Femoral guiding Calibration of femoral viewfinder Install the screw tap e Attach the jig G to the femoral viewfinder Install the
21. ple in this case the distance between the palpated point in the lateral side and the height of cut si 10 mm For chose the reference point you can help you with the topography on the tibia The red 0 point is the higher point and the blue zone is the lowest The distance between the tibial cut red line and the lowest point of the tibial plate is indicated on the opposite side For this example the distance betwwen the tibial cut and the lowest point of the damaged side medial side is 8 mm Like that the height of programmed cut will always be in comparison with the palpated point and the thickness of cut on the opposite side will be indicated for information 33 N AMPLITUDE lal SLOPE HEIGHT ANT POST MED LAT VAR VAL ROTATION Adjust the position of the implant by changing the parameters Lat SIZE SLOPE HEIGHT MED LAT VAR VAL ROTATION Adjust the position of the implant by changing the parameters SIZE SLOPE HEIGHT ANT POST Omm VAR VAL ROTATION Adjust the position of the implant by changing the parameters E Q 0 34 Tibial planning Tibial planning A position and a size of the tibial embase in relation to the cut are proposed The calculated size of the femur is given by way of information The size and position of the implant can be adjusted by using the tactile screen keys To modify a parameter select the position it appears in green
22. rile markers Non resterilisable Box of 14 markers Setting the markers on the jigs 61 Complementary Fixation system F and T Femur Reference Fixation pin Tibial Reference 62 Complementary Complementary to Tibial Navigation Locking of the posterior antero adjustment and of the level of the cut Axial Rotation coloured purple Varus alqus Coloured yellow Level of the cut coloured green in Guide 5 __ d m Lacking of the tibial bracket s the screw tap slope coloured blue Coloured yellow 63 Complementary Cut level colour green varus algus Colour purple Flexum Hecurvatum Colour blue Locking at cut level and ofthe pasteriar fark on the intra medullary stem ar the screw tap Axial rotation Colour Yellow 64 Complementary Align the markers of neutral positians before surgical procedure Green tibial adjusting knob ac Insert knob in the groove Purple Screw gt LA Tibial runner _ Purple arm E B i e MM Blue return Tibial 2 y translation C E axis TT Blue tightening screw Yellow tightening puel Screw Yellow tibia viewfinder 65 Complementary Align markers in neutral positions before surgical procedure Green femoral adjusting knob Cay arm Or o 3 insert knab in groove Purple tightening screw
23. tain the right spacing to fix Clip the rigid part of the femur be careful to respect the direction of the arrows on the movable part of the fixation system If it is necessary during the operation to remove the rigid structure this will be placed in the same way Direct the jig towards the optical head and lock the fixation system Direct and fix the jig so that with the leg flexed or not the jigs can always be seen by the optical head After opening and exposing the knee using the separators provided it is important to do the exeresis of the osteophytes in order to find the right articular surfaces to palpate for the digitalization of articular surfaces otherwise risk of over or under estimating the size of the implant AMPLITUDE Attach the jig Tibia and jig Femur then select the camera orientation 10 Station installation Camera regulating Position the localisator so that the letters indentifying the jigs F and T are in the center of the volume of visibility This adjustment is facilitated by a laser situated in the direction arm of the optical localisator n the lower left corner of the station screen the letters corresponding to the jigs Tibia Femur Probe Pointer Guide appear when they are used in the current stage coloured green when the receptors are visible by the localisator coloured red when they are not detected The invisibility of the jigs may be due to paras
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