Arthroplasty of the knee--indications and contraindications

Total knee arthroplasty has been showed to be a satisfactory procedure mainly in relation to designs evolution of condylar or surface prostheses. In this matter, the concepts of prostheses of Gunston Polycentric (2), Freeman-Swanson (1) and the Total Condylar (3) were particularly important. The present status of development of condylar or surface arthroplasties allows to establish that in the majority of cases, arthrodesis of the knee is a salvage procedure. The alternative procedures indicated must always be considered. The conservative treatments as anti-inflammatory drugs and physiotherapy as well as arthroscopy, arthrotomy, synovectomy and osteotomies can be performed. These procedures are indicated depending on age, joint condition and type of disease. The knee arthroplasty requires skill and training of the surgeon, particularly if we consider the deformities and instabilities to be corrected and joint function to be aimed. On the other hand, the major problem may be the selection of the patient who will be operated on for a given type of total knee arthroplasty.