Summary The Persona® The Personalized Knee® is indicated for total knee arthroplasty in patients with severe knee pain and disability caused by conditions such as rheumatoid arthritis, osteoarthritis, or post-traumatic loss of joint configuration. It achieves optimal component fit and stability through a measured resection technique and a wide variety of anatomically shaped implants that allow for either mechanical or personalized alignment approaches. This system restores a neutral mechanical axis while addressing specific patient needs through versatile constraint options, including cruciate retaining or posterior stabilized designs. Related Implants ROSA® Knee with OptimiZe™ used during primary total knee arthroplasty for skeletally mature patients to enhance alignment accuracy and facilitate intra-operative joint balancing Indications Indications severe knee pain and disability due to rheumatoid arthritis, osteoarthritis, traumatic arthritis, and polyarthritis collagen disorders and avascular necrosis of the femoral condyle post-traumatic loss of joint configuration, particularly with patellofemoral erosion, dysfunction, or prior patellectomy moderate valgus, varus, or flexion deformities Contraindications previous infection in the affected joint local or systemic infection that may affect the prosthetic joint insufficient femoral or tibial bone stock skeletal immaturity Anatomy Osteology distal femur includes medial and lateral femoral condyles, trochlea, intercondylar notch, posterior condyles, and epicondyles proximal tibia includes medial and lateral tibial plateaus, tibial spines, posterior tibial cortex, and tibial tubercle patella articulates with the trochlea and contributes to extensor mechanism function tibial plateau morphology affects tibial component coverage, rotation, and avoidance of overhang Muscles quadriceps mechanism includes the quadriceps tendon, patella, and patellar tendon patellar tendon is at risk during tibial resection and lateral exposure hamstrings influence flexion balance and posterior soft-tissue tension Ligaments ACL is typically absent, deficient, or sacrificed in total knee arthroplasty PCL status influences selection of CR, MC, UC, PS, or CPS bearings PCL-intact knees may be treated with CR or MC constructs depending on balance and surgeon preference PCL-deficient or PCL-sacrificed knees may require MC, UC, PS, or CPS constructs depending on femoral component type and stability MCL integrity is critical for coronal-plane stability and is required for personalized alignment in valgus deformity limits LCL integrity contributes to varus-valgus stability and constraint selection Nerves common peroneal nerve is at risk during severe valgus correction, posterolateral releases, and lateral retraction tibial nerve lies posterior to the knee with the popliteal neurovascular bundle saphenous nerve and infrapatellar branch may be encountered during anterior and medial incisions Blood supply genicular arterial network supplies the periarticular soft tissues and capsule superior medial, superior lateral, inferior medial, and inferior lateral genicular branches contribute to knee perfusion anterior soft-tissue blood supply should be preserved by careful incision planning and flap handling Approach Surgical approach use a midvastus, subvastus, or medial parapatellar arthrotomy according to surgeon preference and patient factors evert or sublux the patella according to exposure needs and surgeon preference inflate the tourniquet with the knee in hyperflexion when using the source-described technique to maximize quadriceps excursion below the tourniquet prep and drape the patient before defining incision landmarks identify patella, tibial tubercle, joint line, distal femur, tibial plateau, and extensor mechanism landmarks retract the tibia anteriorly to improve visualization of the proximal tibia place posterior tibial retractors carefully and subperiosteally against posterior cortex to reduce neurovascular risk Technique Resect Distal Femur drill IM canal using an 8 mm step drill and remove medullary contents via suction assemble 8 mm IM rod, modular handle, and adjustable valgus guide to reproduce anatomic axis alignment align guide against most prominent distal condyle and rotate until engraved lines match epicondylar axis set resection depth on adjustable tower—typically 10 mm at '0' setting—and perform bone cut using a 1.27 mm oscillating saw blade verify cut surface is completely flat to ensure adequate contact for final implant fixation Resect Proximal Tibia assemble extramedullary (EM) alignment guide with proximal tube, distal rod, and ankle clamp align vertical slot of selected 3° or 7° tibial cut guide with medial third of tibial tubercle and center EM guide with mechanical axis use 2 mm stylus tip on defective condyle or 10 mm tip on least involved condyle to establish resection level resect proximal tibia through cut slot, protecting patellar tendon via lateral relief cutout confirm resection is planar using an inverted universal cut guide before removing pins Femoral Sizing & Rotation apply anterior referencing sizer flush against resected distal femur and posterior condyles establish external rotation at 3° or 5° relative to posterior condylar axis using sizer geometry as visual cues adjust sizing boom proximally or distally along anterior cortex and lock in place to reduce notching risk read femoral size from sizer tower and drill 3.2 mm holes for subsequent 4-in-1 cut guide pegs ensure leg is in 70° to 80° flexion during this phase to decrease patellar tendon tension Final Femoral Preparation place anterior referencing 4-in-1 cut guide by aligning posterior pins with previously drilled positioning holes impact guide until flush with femur and verify planned anterior resection level with a resection guide insert 3.2 mm trocar-tipped pins through oblique holes to provide additional fixation stability complete anterior, posterior, posterior chamfer, and anterior chamfer resections through cut slots in specified order remove 4-in-1 guide using slaphammer by engaging locking feature and extracting axially Tibial Sizing & Broaching choose right or left sizing plate that provides maximum tibial coverage without soft tissue overhang align rotation within 5° of axis created by medial third of tubercle and PCL attachment point secure sizing plate with 25 mm screws or shorthead holding pins and verify alignment with alignment rod drill through cemented tibial drill guide until size-specific engraved line reaches guide top impact correct-sized cemented tibial broach until head bottoms out on inserter-extractor handle stop Patellar Preparation evert patella to at least 90° and measure maximum thickness using femur caliper drill highest portion of medial facet 12 mm deep to act as guide for medialized placement set patella osteotomy guide stylus to desired resection level, maintaining at least 10 mm of remaining bone stock. perform flat resection using 1.27 mm saw blade while keeping guide jaws parallel to dorsal surface use sizing template to select largest size without overhang and drill three peg holes Trial Reduction position femoral provisional, tibial sizing plate, and patellar provisional to assess tracking and joint stability assemble Tibial Articular Surface Provisional (TASP) by matching top, shim, and bottom components based on side and constraint test stability in extension and at 30°, 60°, and 90° flexion while verifying spine-cam engagement for PS designs exchange TASP shims in vivo to balance joint space, using thinnest 10 mm construct for initial assessment confirm ligament balance and neutral mechanical axis before proceeding to final component implantation. Final Implantation remove trials and use pulse lavage to clear debris from bone surfaces and joint space apply layer of bone cement to resected surfaces, component undersides, and drilled peg holes impact tibial plate until fully seated and allow cement to cure before trialing range of motion seat femoral component, translating laterally to align pegs with drill holes, and remove excess cement thoroughly secure tibial bearing onto baseplate using articular surface inserter to apply necessary downward and rearward forces. Close Incision irrigate the wound freely before closure close the arthrotomy and wound with sutures according to surgeon preference complete final implant seating, stability, and tracking checks before leaving the operating room Technical specifications Femur Component Feature Size 1 Size 2 Sizes 3-11 Size 12 Profile Availability Narrow only Narrow only Standard and Narrow Standard only Distal Thickness 8 mm 8 mm 9 mm 9 mm CR Posterior Thickness 8 mm 8 mm 9 mm 9 mm PS Posterior Thickness 9 mm 9 mm 10 mm 10 mm Provisional Design No cutouts No cutouts Intermittent cutout No cutouts Tibia tibial baseplates are available in 9 sizes A, B, C, D, E, F, G, H, and J sizing left and right tibial implant options are available disproportional medial-lateral growth Tivanium® Alloy where specified for the anatomic tibia compatibility with stem extensions within supported constructs tibial locking mechanism uses a triple-wedge design does not use lock-down screws or through holes requires cemented nonporous tibial components without a stem extension Bearings Bearing Type PCL Status Compatible Femoral Component Max Thickness CR Intact CR 18 mm MC Intact, Sacrificed, or Deficient CR 20 mm UC Sacrificed or Deficient CR 20 mm PS Deficient / Removed PS 20 mm CPS Deficient / Removed PS 20 mm Patella all-polyethylene patella size options include 26 mm x 7.5 mm 26 mm x 7.5 mm must always be inset 29 mm x 8.0 mm must be inset when used with sizes 10 through 12 Persona PS femoral components 32 mm x 8.5 mm 38 mm x 9.5 mm 41 mm x 10.0 mm Materials and fixation Trabecular Metal™ Technology is a porous tantalum biomaterial designed to replicate cancellous bone-like structure, function, and physiologic properties Vivacit-E® Vitamin-E highly crosslinked polyethylene is designed with antioxidant stabilization Vivacit-E® is intended to help protect polyethylene from oxidation while maintaining wear resistance and strength Screws Screw/pin Screw/Pin Compatible Driver Shipped Sterile/Non-sterile Quantity per Package Single Use 25 mm x 2.5 mm Female Hex Screw 2.5 mm Male Hex Driver Sterile 2 Yes 75 mm x 3.2 mm Trocar Tipped Drill Pin Pin/Screw Inserter Sterile 4 Yes Hex Headed Screw 33 mm long Pin/Screw Inserter Sterile 2 Yes MIS Quad-Sparing™ Total Knee Headed 48 mm long Screw Inserter/Extractor Sterile 1 Yes 25 mm Shorthead Holding Pin Multi Pin Puller Non-Sterile 1 No