An exercise device is provided which comprises a base configured to support the exercise device, an arcuate path extending from the base, a limb support configured to receive a limb of a user and which moves along the arcuate path, and a resistance member attachable to the limb support and configured to provide resistance against movement of the limb support along the arcuate path. The device includes a body attachable to a distal femur, the body having a cutting guide and an adjustment mechanism operable to balance the flexion gap, wherein upon balancing the flexion gap, the cutting guide is operable to guide at least one cut in the distal femur. One or more mesh manipulators are provided on the head and serve to assist in positioning or otherwise manipulating surgical mesh prior to fixation with the staples.