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Evaluations of Designs and Techniques

Which Evaluation Methods Are Applicable, and Are There Differences Between Designs and Techniques?
  • Peter S. Walker
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Abstract

Since artificial knees were introduced, the most widely used evaluation parameter has been survivorship. Countries such as in Scandinavia have been able to collect data on all of their artificial knee cases from the beginning. Results have shown a steady increase in survivorship over the decades, to the point where a great deal of further improvement is un likely. Hence there is now greater attention on functional outcomes. The universal method of assessing function is patient-reported outcome measures (PROMs). While there are numerous versions, the most common are KSS, KOOS, WOMAC, and FJS. These measures have been used to compare different designs of artificial knees, in the expectation that some designs would have superior performance. However, despite the major differences in the mechanics of different designs, there have been few striking functional differences found. The same has applied to different surgical techniques. To obtain more objective comparisons, biomechanical evaluation methods are being used more. The methods include gait and kinetic analysis, fluoroscopy, and basic clinical tests such as TUG or STS. These have in general shown more differences between designs and techniques. Further objectivity has been obtained using laboratory tests machines, and computer modeling. The latter has the advantage of accounting for variations in patient characteristics and surgical variations.

Keywords

Survivorship PROMs Knee Society Score Design comparisons Technique comparisons Biomechanical evaluations Gait analysis Fluoroscopy Computer modeling 

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Peter S. Walker
    • 1
  1. 1.Department of Orthopedic SurgeryNew York UniversityNew YorkUSA

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