The spectrum of prosthesis design for primary total knee arthroplasty

Many types of prostheses are currently used for total knee arthroplasty. Controversy exists, however, regarding which prostheses are the most appropriate for use by individual surgeons and specific patient groups. Six types of prostheses are currently being used in the United States for primary total knee arthroplasty: posterior cruciate ligament-retaining prostheses; posterior cruciate ligament-substituting prostheses; prostheses with ceramic components; mobile-bearing prostheses; nonmodular, compression-molded polyethylene prostheses; and medial-pivot prostheses. The historical and current result of using these different types of prostheses are discussed, and the indications, contraindications, and recommendations for each type are delineated.