> ## Documentation Index
> Fetch the complete documentation index at: https://userguide.tesacloud.com/llms.txt
> Use this file to discover all available pages before exploring further.
# Intraoperative Data Capture
> Recording measurements during surgery
# Intraoperative Data Capture
Capture tension measurements, flexion angles, and other surgical data in real-time.
## Tension Measurements
### Understanding Tension Values
Tesa devices measure graft tension in Newtons (N):
* **Low Tension** - Below optimal range
* **Optimal Range** - Target tension for graft fixation
* **High Tension** - Above recommended range
### Recording Measurements
In Live mode, measurements are captured automatically when you:
1. Position the tensioner
2. Apply tension to the graft
3. Lock the reading
In Manual mode, enter values directly into the data fields.
### Using the Slider Modal
Open the slider modal for precise tension and angle input using one of two methods:
* **Tap the input field** - Tap either the Newtons or Degrees text field
* **Tap the slider button** - Tap the slider icon (tune button) next to the measurement cycle/readings display
Choose a ligament from the dropdown before recording. The modal will not open without a ligament selected.
Tap either the Newtons or Degrees text field, or tap the slider button next to the cycle display
Use the vertical sliders to set tension (0-80N) and angle (0-150°). You can also tap the value display to type a specific number directly.
Use the quick-set chip buttons (0°, 30°, 60°, 90°, 120°, 150°) beside the angle slider to jump to common flexion angles.
Tap the up/down arrows for single-unit adjustments, or tap the value display box to type an exact number
Tap **SAVE** to record the reading. A confirmation message appears and the modal stays open for additional readings.
You must select a ligament before opening the slider modal. If no ligament is selected, a warning message will appear.
### Using the Grid Entry Modal
The grid entry modal provides a spreadsheet-style interface for entering multiple readings at once across standard flexion angles.
* **Tap the grid button** - Tap the grid icon next to the slider button in the measurement cycle/readings display
Choose a ligament from the dropdown before recording. The modal will not open without a ligament selected.
Tap the grid icon button next to the slider button
Type tension values (in Newtons) for each angle row. The grid has pre-set rows for 0°, 30°, 60°, 90°, 120°, and 150°. If using dual tensioners, both T1 and T2 columns are shown.
Tap the radio button in the **Fix** column to mark one row as the fixation point. Tap it again to deselect if chosen inadvertently.
Tap **SAVE** to record all filled rows at once
The grid modal is ideal for entering a full set of measurements across standard angles quickly, rather than adjusting sliders one reading at a time.
### Measurement Cycle Management
The modal header shows the current measurement cycle with a count of saved readings:
* **Measurement Cycle pill** - Displays "Measurement Cycle X (Y saved)" showing the current cycle and how many readings have been recorded
* **Increment button (+)** - Tap to start a new measurement cycle
* **CKM count** - Enter the number of Cyclic Knee Motions (CKMs) performed before this measurement cycle
* **Cycle persistence** - The modal opens on the highest cycle number you've recorded
The cycle increment button is disabled once a reading is fixated, ensuring no additional cycles are added after fixation.
### Cyclic Knee Motions (CKMs)
Between measurement cycles, surgeons typically perform Cyclic Knee Motions — full range-of-motion pumps to condition the graft. You can record the CKM count for each measurement cycle:
* **In the Slider Modal** - Enter the CKM count in the text field next to the "CKMs" label in the measurement cycle header
* **In the Grid Modal** - Enter the CKM count in the same location in the grid modal header
* The CKM count is saved automatically when you save a reading
CKM counts are displayed in the Tension Through RoM chart:
* **Chart legend** - Shows CKM count in brackets next to each cycle label (e.g., "C2:3m (5 CKMs)")
* **Data tab** - Shows a "Round X Cyclic Knee Motion Count: Y" row above each measurement cycle's readings
### Fixating a Reading
To mark a reading as the final fixation point:
Adjust the tension and angle sliders to your fixation values (or fill in the grid row)
**Slider modal**: Tap the **Unfixated** button below the tension slider - it changes to **Fixated**.
**Grid modal**: Tap the radio button in the **Fix** column for the appropriate angle row.
Tap **SAVE** - in the slider modal, the modal closes automatically when a fixated reading is saved
When a reading is fixated:
* A **lock icon** appears on the main page next to the cycle/readings display
* The fixated tension and angle values are shown in the text fields
* The cycle increment button is disabled
### Fixation Locking Effects
Once a tensioner has a fixated reading, several controls become disabled to prevent accidental changes:
| Control | Effect When Locked |
| -------------------------- | --------------------------------------- |
| Tension slider | Disabled - cannot adjust newtons value |
| Angle slider | Disabled when ALL tensioners are locked |
| Cycle (+) button | Disabled - cannot add new cycles |
| Tensioner Readings (voice) | Disabled when ALL tensioners are locked |
The SAVE button remains enabled while you are setting up a fixated reading. It only disables after the fixated reading has been saved. Case Note voice recording also remains available regardless of fixation state.
### Unlocking a Fixated Reading
If you need to change the fixation point or record additional cycles:
Tap the **chart icon** next to the cycle/readings display to open the Tension Through RoM modal
Swipe or tap to switch to the **Data** tab
Find the fixated reading (marked with a red indicator) and tap the **X** button to delete it
Confirm the deletion when prompted
Deleting the fixated reading will unlock all controls for that tensioner. You can then record additional cycles and create a new fixation when ready.
## Voice Recording
The floating microphone button enables hands-free input. Tap the microphone to choose what you want to record:
### Case Note
Opens the standard note editor where you can dictate observations:
Select **Case Note** from the menu
Dictate your observation clearly
Edit the transcription if needed, then save
### Tensioner Readings
Record tension and angle measurements using voice commands:
Select **Tensioner Readings** from the menu
Speak your readings using the command syntax below
The Tension Through RoM chart displays automatically
#### Voice Command Syntax
| Command | Example | Result |
| --------------------- | ----------------------------------------- | ---------------------------------------------------- |
| Basic reading | "30 degrees 15 pounds" | Records angle 30°, tension 15 |
| With tensioner | "Tensioner 1, 45 degrees, 20 pounds" | Records to specific tensioner |
| Fixation | "Fixate 30 at 15" | Records as fixated reading |
| Multiple readings | "30 at 15, 45 at 18, 60 at 20" | Records several readings |
| Set cycle | "Cycle 2" | Sets cycle number to 2 |
| Set measurement cycle | "Measurement cycle 3" or "Measurement 3" | Sets measurement cycle to specified number |
| New cycle | "New cycle" or "Next cycle" | Increments cycle by 1 |
| New measurement | "New measurement" or "Next measurement" | Increments measurement cycle by 1 |
| Set CKM count | "After 10 cycles" or "10 CKMs" | Sets CKM count for the current cycle and saves to DB |
| Set CKM count (alt) | "After 10 pumps" or "10 pumps" | Sets CKM count for the current cycle and saves to DB |
| Ligament selection | "ACL", "PCL", "MCL", "LCL", "MPFL", "ALL" | Selects the specified ligament |
Voice guidance text is displayed above the sound wave animation while recording tensioner readings, showing the expected command format.
Speak clearly and include both the angle (degrees) and tension (pounds) for each reading.
## Range of Motion Measurement Cycles
Measurement cycles allow you to track multiple range-of-motion passes through the joint. Each measurement cycle represents a complete sweep through the range of motion, typically separated by Cyclic Knee Motions (CKMs).
### Why Use Measurement Cycles?
During surgery, you may need to:
* Check tension at multiple points before final fixation
* Compare tension patterns across different conditioning passes
* Document how the graft responds over successive range-of-motion cycles
* Track the number of CKMs performed between each measurement cycle
### Recording Measurement Cycles
Begin with Measurement Cycle 1 (default) and record your first pass through the range of motion
Perform your Cyclic Knee Motions to condition the graft
Say **"new cycle"**, **"new measurement"**, or **"next measurement"** via voice command, or tap the **+** button in the modal's cycle pill. Enter the number of CKMs performed in the CKM field, or say **"after 10 cycles"** or **"10 CKMs"** to set the count by voice.
Record your next pass - readings are assigned to the new measurement cycle number
The measurement cycle number and saved readings count are displayed in the modal header. Once you fixate a reading, the cycle increment button is disabled to prevent additional cycles after fixation.
### Understanding the Cycle Display
Each measurement cycle appears as a separate line on the chart:
| Cycle | Color | Line Width |
| -------------------- | ------ | ---------- |
| Measurement Cycle 1 | Purple | 1px |
| Measurement Cycle 2 | Blue | 2px |
| Measurement Cycle 3 | Green | 3px |
| Measurement Cycle 4+ | Orange | 4px |
The legend shows elapsed time and CKM count for each cycle, helping you understand the timing and conditioning between measurement cycles (e.g., "C2:3m (5 CKMs)").
## Flexion Angles
Record the knee flexion angle at each tension measurement. The angle slider ranges from 0° to 150° with quick-set buttons for common positions:
| Angle | Position |
| ----- | ---------------- |
| 0° | Full extension |
| 30° | Slight flexion |
| 60° | Moderate flexion |
| 90° | Deep flexion |
| 120° | Deep flexion |
| 150° | Maximum flexion |
Use the quick-set angle chip buttons beside the slider to jump directly to standard flexion angles, or tap the value display to type a specific angle.
## Tension Through RoM Chart
View tension measurements plotted against joint angle in a tabbed modal interface.
### Chart Tab
The chart displays tension readings with:
* **Colored lines** - Each measurement cycle shown in a different color (purple, blue, green, orange)
* **Line thickness** - Increases from 1px to 4px based on cycle number
* **Red dot** - Fixated reading indicating final fixation point
* **Legend** - Shows cycle numbers with time elapsed and CKM count (e.g., "C1:0m", "C2:3m (5 CKMs)")
### Data Tab
View all readings in a sortable list:
* **Format** - `[cycle] tensionN at angle° [attachment]`
* **Sorting** - By cycle number, then by angle ascending
* **CKM rows** - A "Round X Cyclic Knee Motion Count: Y" row appears above the start of each measurement cycle (cycle 2+) showing how many CKMs were performed before that cycle
* **Delete** - Remove individual readings with the X button
Swipe between tabs to quickly switch between the visual chart and detailed data view.
### Fixation Rules
Only **one fixated reading** is allowed per procedure. If you need to change the fixation point, delete the existing fixated reading first using the Data tab.
To fixate a reading:
1. Open the slider modal by tapping the Newtons or Degrees field, or by tapping the slider button next to the cycle display
2. Set the tension and angle values using the sliders
3. Tap the **Unfixated** button to change it to **Fixated**
4. Tap **SAVE** - the modal closes automatically
Alternatively, use the grid modal:
1. Open the grid modal by tapping the grid button next to the slider button
2. Enter tension values for your angle rows
3. Tap the radio button in the **Fix** column for the fixation row
4. Tap **SAVE**
The fixated point represents the final tension at which the graft was fixed. A lock icon appears on the main page when fixation is complete.
## Adding Notes
Document surgical findings during the procedure:
Tap the **Add Note** button or use voice recording
Type your observation or use voice-to-text
Notes are timestamped automatically
## Capturing Images
Add visual documentation to the procedure:
### Camera Capture
* Click **Camera** to take a photo
* Image is automatically attached to the procedure
### DICOM Upload
* Upload medical imaging files (X-ray, MRI, CT)
* View DICOM images with multi-frame support
* Images are securely stored with the procedure record
## Recording Status Indicators
| Indicator | Meaning |
| ------------------ | ------------------------ |
| Blue microphone | Ready to record |
| Red microphone | Recording in progress |
| Animated soundwave | Voice capture active |
| Spinning indicator | Processing transcription |
## Completing the Procedure
When finished:
Verify all measurements are recorded
Confirm the fixated reading is correct
Document any closing observations
Click **Complete** to finalize the record