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Current Status of Total Knee Arthroplasty

Current Status of Total Knee Arthroplasty Abstract • Total knee arthroplasty has become an acceptable method of surgical management for severe, disabling gonarthropathy. The three major biomechanical classifications of total knee prostheses are minimally constrained, partially constrained, and fully constrained. The major indication for total knee arthroplasty is pain, followed in a much lower frequency by instability, loss of motion, and deformity. The principal contraindications for the various types relate solely to the residual or restorable ligamentous stability of the knee and the degree of bone loss. In general, the greater the instability and bone loss, the more constrained the prosthesis must be. Theoretically, loosening rates increase with increasing shear stresses, which are generally highest with the most constrained prostheses. The major complications are sepsis, loosening, and instability. Various prostheses have incorporated patellofemoral resurfacing as the final dimension in producing a total knee arthroplasty. Knee arthroplasty is very effective in preserving functional knee motion, with relief of pain as an alternative to arthrodesis. (Arch Surg 112:1099-1104, 1977) References 1. Verneuil A: Résultats obtenus en France par l'opération d'Esmarch: Examen des causes d'insuccés et moyens d'y remédier . Gaz Hebd Med 10:97-102, 1863. 2. Potter TA: Arthroplasty of the knee with tibial metallic implants of the McKeever and MacIntosh design . Surg Clin North Am 49:903-915, 1969. 3. MacIntosh DL, Hunter GA: The use of hemiarthroplasty prosthesis for advanced osteoarthritis and rheumatoid arthritis of the knee . J Bone Joint Surg 54B:244-255, 1972. 4. Walldius B: Arthroplasty of the knee using an endoprosthesis: Eight years' experience . Acta Orthop Scand 30:137-148, 1960.Crossref 5. Jones GB: Total knee replacement: The Walldius hinge . Clin Orthop 94:50-57, 1973.Crossref 6. Gunston FH: Polycentric knee arthroplasty: Prosthetic simulation of normal knee movement . J Bone Joint Surg 53B:272-277, 1971. 7. Gunston FH: Polycentric knee arthroplasty: Prosthetic simulation of normal knee movement; interim report . Clin Orthop 94:128-135, 1973.Crossref 8. Bryan RS, Peterson LFA, Combs JJ Jr: Polycentric knee arthroplasty: A preliminary report of postoperative complications in 450 knees . Clin Orthop 94:148-152, 1973.Crossref 9. Shoji H, D'Ambrosia RD, Lipscomb PR: Failed polycentric total knee prostheses . J Bone Joint Surg 58A:773-777, 1976. 10. Skolnick MD, Bryan RS, Peterson LFA, et al: Polycentric total knee arthroplasty: A two-year follow-up study . J Bone Joint Surg 58A:743-748, 1976. 11. Marmor L: The modular knee . Clin Orthop 94:242-248, 1973.Crossref 12. Laskin RS: Modular total knee-replacement arthroplasty: A review of eighty-nine patients . J Bone Joint Surg 58A:766-773, 1976. 13. Marmor L: Modular (Marmor) knee: Case report with a minimum follow-up of two years . Clin Orthop 120:86-94, 1976. 14. Bargren JH, Freeman MAR, Swanson SAV, et al: ICLH (Freeman/ Swanson) arthroplasty in the treatment of arthritic knee: A two to fouryear review . Clin Orthop 120:65-75, 1976. 15. Coventry MB, Finerman G, Riley LH Jr, et al: Early results with geometric total knee arthroplasty , abstracted. J Bone Joint Surg 55A:1321, 1973. 16. Skolnick MD, Coventry MB, Ilstrup DM: Geometric total knee arthroplasty: A two-year follow-up study . J Bone Joint Surg 58A:749-753, 1976. 17. Waugh TR, Smith RC, Orofino CF, et al: Total knee replacement: Operative technic and preliminary results . Clin Orthop 94:196-201, 1973.Crossref 18. Evanski PM, Waugh TR, Orofino CF, et al: UCI knee replacement . Clin Orthop 120:33-38, 1976. 19. Freeman MAR, Swanson SAV, Todd RC: Total replacement of the knee using the Freeman-Swanson knee prosthesis . Clin Orthop 94:153-170, 1973.Crossref 20. Mazas FB, GUEPAR: Guepar total knee prosthesis . Clin Orthop 94:211-221, 1973.Crossref 21. Deburge A: GUEPAR hinge prosthesis: Complications and results with two years' follow-up . Clin Orthop 120:47-53, 1976. 22. Shiers LGP, cited by Arden GP: Total knee replacement . Clin Orthop 94:92-103, 1973. 23. Matthews LS, Sonstegard DA, Kaufer H: The spherocentric knee . Clin Orthop 94:234-241, 1973.Crossref 24. Aglietti P, Insall JN, Walker PS, et al: A new patella prosthesis: Design and application . Clin Orthop 107:175-187, 1975.Crossref 25. Kettelkamp DB, Nasca R: Biomechanics and knee replacement arthroplasty . Clin Orthop 94:8-14, 1973.Crossref 26. Shaw JA, Murray DG: Knee joint simulator . Clin Orthop 94:15-23, 1973.Crossref 27. Nogi J, Caldwell JW, Kauzlarich JJ, et al: Load testing of geometric and polycentric total knee replacements . Clin Orthop 114:235-242, 1976. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Current Status of Total Knee Arthroplasty

Peterson, Lowell F. A.
Archives of Surgery , Volume 112 (9) – Sep 1, 1977
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References (28)

Publisher
American Medical Association
Copyright
Copyright © 1977 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1977.01370090081017
Publisher site
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Abstract

Abstract • Total knee arthroplasty has become an acceptable method of surgical management for severe, disabling gonarthropathy. The three major biomechanical classifications of total knee prostheses are minimally constrained, partially constrained, and fully constrained. The major indication for total knee arthroplasty is pain, followed in a much lower frequency by instability, loss of motion, and deformity. The principal contraindications for the various types relate solely to the residual or restorable ligamentous stability of the knee and the degree of bone loss. In general, the greater the instability and bone loss, the more constrained the prosthesis must be. Theoretically, loosening rates increase with increasing shear stresses, which are generally highest with the most constrained prostheses. The major complications are sepsis, loosening, and instability. Various prostheses have incorporated patellofemoral resurfacing as the final dimension in producing a total knee arthroplasty. Knee arthroplasty is very effective in preserving functional knee motion, with relief of pain as an alternative to arthrodesis. (Arch Surg 112:1099-1104, 1977) References 1. Verneuil A: Résultats obtenus en France par l'opération d'Esmarch: Examen des causes d'insuccés et moyens d'y remédier . Gaz Hebd Med 10:97-102, 1863. 2. Potter TA: Arthroplasty of the knee with tibial metallic implants of the McKeever and MacIntosh design . Surg Clin North Am 49:903-915, 1969. 3. MacIntosh DL, Hunter GA: The use of hemiarthroplasty prosthesis for advanced osteoarthritis and rheumatoid arthritis of the knee . J Bone Joint Surg 54B:244-255, 1972. 4. Walldius B: Arthroplasty of the knee using an endoprosthesis: Eight years' experience . Acta Orthop Scand 30:137-148, 1960.Crossref 5. Jones GB: Total knee replacement: The Walldius hinge . Clin Orthop 94:50-57, 1973.Crossref 6. Gunston FH: Polycentric knee arthroplasty: Prosthetic simulation of normal knee movement . J Bone Joint Surg 53B:272-277, 1971. 7. Gunston FH: Polycentric knee arthroplasty: Prosthetic simulation of normal knee movement; interim report . Clin Orthop 94:128-135, 1973.Crossref 8. Bryan RS, Peterson LFA, Combs JJ Jr: Polycentric knee arthroplasty: A preliminary report of postoperative complications in 450 knees . Clin Orthop 94:148-152, 1973.Crossref 9. Shoji H, D'Ambrosia RD, Lipscomb PR: Failed polycentric total knee prostheses . J Bone Joint Surg 58A:773-777, 1976. 10. Skolnick MD, Bryan RS, Peterson LFA, et al: Polycentric total knee arthroplasty: A two-year follow-up study . J Bone Joint Surg 58A:743-748, 1976. 11. Marmor L: The modular knee . Clin Orthop 94:242-248, 1973.Crossref 12. Laskin RS: Modular total knee-replacement arthroplasty: A review of eighty-nine patients . J Bone Joint Surg 58A:766-773, 1976. 13. Marmor L: Modular (Marmor) knee: Case report with a minimum follow-up of two years . Clin Orthop 120:86-94, 1976. 14. Bargren JH, Freeman MAR, Swanson SAV, et al: ICLH (Freeman/ Swanson) arthroplasty in the treatment of arthritic knee: A two to fouryear review . Clin Orthop 120:65-75, 1976. 15. Coventry MB, Finerman G, Riley LH Jr, et al: Early results with geometric total knee arthroplasty , abstracted. J Bone Joint Surg 55A:1321, 1973. 16. Skolnick MD, Coventry MB, Ilstrup DM: Geometric total knee arthroplasty: A two-year follow-up study . J Bone Joint Surg 58A:749-753, 1976. 17. Waugh TR, Smith RC, Orofino CF, et al: Total knee replacement: Operative technic and preliminary results . Clin Orthop 94:196-201, 1973.Crossref 18. Evanski PM, Waugh TR, Orofino CF, et al: UCI knee replacement . Clin Orthop 120:33-38, 1976. 19. Freeman MAR, Swanson SAV, Todd RC: Total replacement of the knee using the Freeman-Swanson knee prosthesis . Clin Orthop 94:153-170, 1973.Crossref 20. Mazas FB, GUEPAR: Guepar total knee prosthesis . Clin Orthop 94:211-221, 1973.Crossref 21. Deburge A: GUEPAR hinge prosthesis: Complications and results with two years' follow-up . Clin Orthop 120:47-53, 1976. 22. Shiers LGP, cited by Arden GP: Total knee replacement . Clin Orthop 94:92-103, 1973. 23. Matthews LS, Sonstegard DA, Kaufer H: The spherocentric knee . Clin Orthop 94:234-241, 1973.Crossref 24. Aglietti P, Insall JN, Walker PS, et al: A new patella prosthesis: Design and application . Clin Orthop 107:175-187, 1975.Crossref 25. Kettelkamp DB, Nasca R: Biomechanics and knee replacement arthroplasty . Clin Orthop 94:8-14, 1973.Crossref 26. Shaw JA, Murray DG: Knee joint simulator . Clin Orthop 94:15-23, 1973.Crossref 27. Nogi J, Caldwell JW, Kauzlarich JJ, et al: Load testing of geometric and polycentric total knee replacements . Clin Orthop 114:235-242, 1976.

Journal

Archives of Surgery – American Medical Association

Published: Sep 1, 1977

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