Abstract:

Advances in surgical technique and implant design have increased the treatment options available to joint reconstruction surgeons. New technologies for component alignment such as custom cutting blocks and disposable cutting blocks hold the potential for more anatomic component positioning and less instrument turnover which may decrease infection rates. Improved component alignment may also be obtained with the use of computer-assisted surgery. Utilization of bone-sparing designs such as patellofemoral, unicompartmental, and bicompartmental knee arthroplasty allow for the surgeon to customize treatment based on patient symptoms by addressing each compartment individually. Gender-specific designs may be useful in the setting of populations which deviate from standard dimensions that are available in traditional unisex designs. New higher-conforming bearing designs such as rotating platform bearings allow for more natural knee kinematics, while also limiting polyethylene wear by decreasing contact stress. Newer interfaces for cementless fixation utilizing porous coated surfaces allows for biologic component fixation which has the potential to increase interface durability and implant survivorship. These new materials, designs, and techniques are challenging the traditional "gold standard" cemented total knee arthroplasty and have the potential for developing a more durable and naturally feeling prosthetic knee. Further study is required to identify which patients are most appropriate for each new technology.

Authors:

Qais Naziri, MD, Fellow, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, MD, Robert Pivec, MD, Fellow, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement Sinai Hospital of Baltimore, Baltimore, MD, Steven F. Harwin, MD, FACS, Chief of Adult Reconstructive Surgery and Total Joint, Replacement, The Center for Reconstructive Joint Surgery, Beth Israel Medical Center, New York, NY, Christopher R. Costa, MD, Fellow, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, Aaron J. Johnson, MD, Fellow, Rubin Institute for Advanced Orthopedics Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD, Peter M. Bonutti, MD, Director, Bonutti Clinic, Effingham, IL, Michael A. Mont, MD, Co-Director, Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, Baltimore, MD

PMID: 22915499

For Direct IP Access please click this link