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Set Up Guide:

The RAMP™ 
Knee Positioning System

Surgical Videos

Belt Attachment 

1.  Insert belts downward through the lateral side belt slots with the labels facing medially.

2. Loop the belts underneath the OR table.

3. Run belts up through the medial side belt slots,  then secure the Velcro firmly. 

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RAMP Setup

1. Initial Positioning

Position the RAMP on the OR table leg section centered under the operative leg with the Achilles tendon resting on the tallest footrest.


2. Adjust Position

Slightly adjust proximal / distal position to the surgeons liking.  

*In some cases, 90° of flexion is desired with the foot on the 3rd footrest. A goniometer can be a useful tool to achieve this.


3. Install Belts

Install both belts to secure position. We recommend one staff member holds and moves the patient’s legs as needed while another installs the belts.


4. Lateral Support and Hip Elevation 

Set up the lateral support to prevent the leg from falling laterally, even in hyperflexion. This can usually be achieved by placing the support near the tourniquet.


Place a bump (rolled up towel, etc.) under the patient’s hip to prevent the foot from externally rotating. 


5. Skin Preparation

Wrap the non-operative leg (or use a drape) to prevent it from directly contacting the belts. 


Place a barrier (towel, etc.) between the RAMP and operative leg before applying the skin preparation agent.


Installing the belts


After final positioning, the two Velcro belts should be installed to secure the RAMP™ position. The RAMP™ also has rubber feet to resist movement.

We recommend one staff member holds and moves the patient’s legs as needed while another installs the belts.

*Patient legs not shown for clarity

1. Orient the belt with the white label facing inwards (medially).

Belts 1.jpg


2. Insert the belt vertically downward through the operative side belt slot, and feed the belt until the dowel stops the belt from advancing.


3. Bring the belt under the OR table leg section and up through the belt slot on the non-operative side.

Belts 3.jpg


4. While holding the RAMP™ in position, pull the belt tight, secure the Velcro, and repeat for the second belt.

*If increased stability is required, the straps can be installed medial of the OR table siderails and proximal of the siderail standoffs. More details on this can be found in the RAMP IFU.

Belts 4.jpg
*Draping procedures vary. The following is shown as an example. 

1. Down Sheet

- Have one staff member hold the operative leg up

- Install down sheet

- Push drape down between footrests


*Repeat if multiple drapes are used

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2. U-drape

- Attach U-drape

- Push drape down between footrests

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3. Stockinette

- Cover the leg with a stockinette


4. Knee-O-Drape

- Slide the leg through the Knee-O-Drape

- Push drape down between footrests


5. Final Steps

- Wrap the foot in Coban

- Cut a hole in the stockinette

- Apply the incise drape

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