CURRENT CONCEPTS OF TOTAL KNEE ARTHROPLASTY

Total knee arthroplasty has become a reliable surgical procedure to tr eat painful degenerative arthritis. Pain relief and functional improve ment is excellent and can allow patients to maintain an active lifesty le. Criteria for the type of prostheses selected should include diagno sis, age, functional level, severity of the disease, and patient expec tations. Improved instrumentation, attention to surgical detail, inclu ding soft tissue balancing of the knee, and the use of polyethylene in serts greater than 8 mm have led to excellent long-term results and lo w failure rates. Recent improvements in revision total knee systems sh ould significantly improve the long-term results of revision knee arth roplasty. The addition of modular implants has greatly increased the v ersatility of most systems and allows the surgeon to custom tailor the implant, contingent upon the amount of bony and ligamentous deficienc y of the knee. The future goals of total knee arthroplasty include the development of knee systems that mimic normal joint kinematics with i mproved fixation and decreased polyethylene wear rates.