Long term survival of total knee arthroplasty. Lessons learn from the clinical outcome of old designs. Second generation of implants and the total condylar TKA

Abstract

Following the clinical application of the first generation of total knee arthroplasties (TKAs), the evolution of TKA was rapid and impressive. Better understanding of knee kinematics, improvements in surgical techniques and manufacturing of durable materials and designs led to substantial developments in the field of TKA. Two main trends were to become apparent - the functional and anatomical technical approaches. The initial designs of both approaches showed satisfactory clinical outcomes and lower complication rates, although problems with aseptic loosening, instability and patellofemoral pain were still encountered. The introduction of total condylar and rotating platform implants was a crucial step, since all modern prostheses have been influenced by these two knee types. © Springer-Verlag London 2015.