TruMatch Surgeon Registration Form

Register a Surgeon

Title

First Name

Last Name

Phone

Phone Number Extension

Country

Secondary Contact

Name

Phone

Country

Sales Rep Contact Information

First Name

Last Name

Register a Facility

Facility Information

Facility Name

Facility Type

Imaging Center

Primary Contact Information

Name

Sales Region

Sold to Party UCN

Phone Number

Phone Number Extension

Physical Address

Address 1

Address 2

Country

City

State/Province

Postal Code

Alternate Contacts

Name

Phone Number

Phone Number Extension

Name

Phone Number

Phone Number Extension

Implant and Guide Type Preferences

Implant System

Resection Guide Kit Type

Pin Guide Kit Type

Alignment Type

Femoral Component

Tibial Component

Surgical Technique Preferences

Distal femur landmark

Additional distal femur resection to be automatically added when a flexion contracture greater than 10° is observed in the image (mm)

Distal femur resection distance (mm)

Femoral component rotation landmark

External rotation angle relative to landmark above (degree)

2nd choice femoral component rotation landmark if 1st is not detectable

2nd choice external rotation angle relative to landmark above (degree)

Femoral sizing reference and AP positioning reference

When between sizes do you normally up or downsize

Acceptable limit to shift femoral implant AP when in between sizes (mm)

Acceptable limit to flex femoral implant when in between sizes (degree)

Tibia resection landmark

Tibia resection distance (mm)

Additional tibia resection to be automatically added when a flexion contracture greater than 10° is observed in the image (mm)

Tibia slope angle (degree)

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