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Recent advances in total knee replacement surgery
1Hospital for Special Surgery, New York, New York, USA.
Current Opinion in Rheumatology
|March 1, 1995
Summary
Cemented total knee replacement offers predictable pain relief for knee arthritis. Cementless designs and certain unicompartmental implants require further development to improve longevity and avoid early failure.
Area of Science:
- Orthopedic surgery
- Biomaterials science
- Rheumatology
Background:
- Knee arthritis treatment has advanced with total knee replacement (TKR) designs.
- Cemented TKR demonstrates excellent long-term outcomes.
- Cementless TKR and unicompartmental knee replacement (UKR) face challenges.
Purpose of the Study:
- To review the evolution of TKR designs and techniques.
- To assess the success of cemented versus cementless TKR.
- To identify areas for improvement in knee replacement technology.
Main Methods:
- Review of existing literature on TKR and UKR.
- Analysis of implant designs, materials, and clinical outcomes.
- Discussion of complications such as infection, mechanical failure, and wear.
Main Results:
- Cemented TKR provides predictable, long-lasting pain relief for knee arthritis.
- Cementless TKR designs with thin polyethylene and high-contact stress lead to early failure.
- UKR is suitable for focal arthritis, but thin polyethylene designs should be avoided.
Conclusions:
- Cemented TKR remains a reliable option for knee arthritis.
- Improvements in cementless TKR designs are needed to match cemented outcomes.
- Further research should focus on reducing infection, mechanical failure, and wear-debris generation in knee replacements.