Choices, Compromises, and Controversies in Total Knee Arthroplasty. Instr Course Lect 2019;68:187-216
Date
02/08/2020Pubmed ID
32032126Abstract
Although condylar total knee arthroplasty (TKA) has been performed for almost 40 years, many choices, compromises, and controversies remain. In the effort to provide optimal care and beneficial, enduring treatment for an expanding population of patients with debilitating arthritis of the knee and who are using ever-diminishing provider and financial resources, orthopaedic surgeons must carefully examine the available evidence to determine best practices. First, there is debate as to who should be a candidate for TKA. Beyond the established criteria of disease severity, should all patients who can benefit from TKA undergo the procedure, or should surgeons develop exclusion criteria based on complication risk? Current concepts for identifying and managing modifiable risk factors should be considered. Second, there is debate regarding the choice of TKA versus partial knee arthroplasty to manage unicompartmental arthritis. Third, surgeons continue to debate the ideal implant design for primary condylar TKA, whether to proceed with an anatomic approach of preserving one or both cruciate ligaments or a functional approach of resecting and substituting for the cruciate ligaments in various ways.
Author List
Lombardi AV Jr, Berend KR, Tria AJ Jr, Peters CL, Kagan R, Callaghan JJ, Iorio R, Lieberman JR, Della Valle CJ, Calkins TE, Barrack RL, Edelstein AI, Barnes CL, Mears SCMESH terms used to index this publication - Major topics in bold
ArthritisArthroplasty, Replacement, Knee
Humans
Knee Joint
Knee Prosthesis
Osteoarthritis, Knee
Risk Factors
