Advertisement

Discussion and Future Possibilities

How Has the Present Status Been Reached, and What Further Advances Can Be Made?
  • Peter S. Walker
Chapter
  • 28 Downloads

Abstract

It is now just over 50 years since the first artificial knees were invented. Based on data from the recently formed American Joint Replacement Registry, two design types dominate the market, the cruciate retaining (CR) type and the posterior stabilized (PS) type. Both were designed by 1980. It can be asked why these designs became successful. Among the reasons are the influence of the designers and their institutions, the inertia built up by manufacturers, familiarity in the operating room, and satisfactory survivorship and function. Even though several new design types have been introduced before and since 1980, they have not been shown to be superior using PROM evaluations. This however may be partly a limitation of PROMs in distinguishing differences. Nevertheless there are several factors where a new design or technique could be accepted and gain market share. The criteria include greater durability, improved function, quicker recovery time, increased flexion, reduced time and cost of surgery, and strong research and educational support. It is concluded that artificial knees will be used for a long time in the future, on the grounds that they are likely to remain as an effective treatment for arthritis, and there will be further improvements to artificial knees in the coming years.

Keywords

CR knee PS knee Artificial knee success PROMs Criteria for success Criteria for improvement Future of artificial knees Knee osteoarthritis treatment 

References

  1. Aglietti P, Buzzi R, De Felice R, Giron F. The Insall-Burstein total knee replacement in osteoarthritis: a 10-year minimum follow-up. J Arthroplast. 1999;14(5):560–5.CrossRefGoogle Scholar
  2. Arno S, Maffei D, Walker PS, Schwarzkopf R, Desai P, Steiner GC. Retrospective analysis of total knee arthroplasty cases for visual, histological, and clinical eligibility of unicompartmental knee arthroplasties. J Arthroplast. 2011;26(8):1396–403.CrossRefGoogle Scholar
  3. Atrey A, Edmondson MC, East D, Miles K, Butler-Manuel A, Ellens N. A retrospective medium- to long-term results of 1500 AGC total knee replacements - an independent Centre functional follow up and survivorship. J Orthop. 2014;11(1):37–42.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Barrett TJ, Shi L, Parsley BS. Bicruciate-retaining total knee arthroplasty, a promising technology, that’s not quite there. Ann Transl Med. 2017;5(Suppl 1):S17.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Bosco JA, Harty JH, Iorio R. Bundled payment arrangements: keys to success. J Am Acad Orthop Surg. 2018;26(23):817–22.CrossRefGoogle Scholar
  6. Boylan M, Suchman K, Vigdorchik J, Slover J, Bosco J. Technology-assisted hip and knee arthroplasties: an analysis of utilization trends. J Arthroplast. 2018;33(4):1019–23.CrossRefGoogle Scholar
  7. Bozic KJ. My own joint replacement was a reality check. AAOS Now, Aug 2019.Google Scholar
  8. Brandt KD, Dieppe P, Radin EL. Etiopathogenesis of osteoarthritis. Rheum Dis Clin N Am. 2008;34:531–59.CrossRefGoogle Scholar
  9. Chughtai M, Kelly JJ, Newman JM, et al. The role of virtual rehabilitation in total and unicompartmental knee arthroplasty. J Knee Surg. 2019;32(01):105–10.CrossRefGoogle Scholar
  10. Dennis DA, Komistek RD, Scuderi GR, Zingde S. Factors affecting flexion after total knee arthroplasty. Clin Orthop Relat Res. 2007;464:53–60.PubMedPubMedCentralGoogle Scholar
  11. Dunbar M, Gross M. Critical steps in total knee arthroplasty. Int Orthop. 1995;19(5):265–8.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Evans JT, Walker RW, Evans JP, Blom AW, Sayers A, Whitehouse MR. How long does a knee replacement last? A systematic review and meta-analysis of case series and national registry reports with more than 15 years of follow-up. Lancet (London, England). 2019;393(10172):655–63.CrossRefGoogle Scholar
  13. Harvey LA, Brosseau L, Herbert RD. Continuous passive motion following total knee arthroplasty in people with arthritis. Cochrane Database Syst Rev. 2014;(2):Cd004260.Google Scholar
  14. Heyse TJ, Chen DX, Kelly N, Boettner F, Wright TM, Haas SB. Matched-pair total knee arthroplasty retrieval analysis: oxidized zirconium vs. CoCrMo. Knee. 2011;18(6):448–52.CrossRefPubMedPubMedCentralGoogle Scholar
  15. Hooper J, Schwarzkopf R, Fernandez E, Buckland A, Werner J, Einhorn T, Walker PS. Feasibility of single-use 3D-printed instruments for total knee arthroplasty. Bone Joint J. 2019;101-B(7_Supple_C):115–20.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Johnstone B, Jacobs JJ, Sandell LJ, Wilkinson LM. Regenerative medicine will make orthopaedic implants obsolete in our time. J Orthop Res. 2018;36:2579–85.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Kim KY, Anoushiravani AA, Chen KK, Li R, Bosco JA, Slover JD, Iorio R. Perioperative orthopedic surgical home: optimizing total joint arthroplasty candidates and preventing readmission. J Arthroplast. 2019;34(7S):S91–6.CrossRefGoogle Scholar
  18. Laskin RS, Maruyama Y, Villaneuva M, Bourne R. Deep-dish congruent tibial component use in total knee arthroplasty: a randomized prospective study. Clin Orthop Relat Res. 2000;380:36–44.CrossRefGoogle Scholar
  19. Mahfouz M, Fatah EEA, Bowers LS, Scuderi G. Three-dimensional morphology of the knee reveals ethnic differences. Clin Orthop Relat Res. 2012;470:172–85.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Meier M, Zingde S, Steinert A, Kurtz W, Koeck F, Beckmann J. What is the possible impact of high variability of distal femoral geometry on TKA? A CT data analysis of 24,042 knees. Clin Orthop Relat Res. 2019;477(3):561–70.CrossRefPubMedPubMedCentralGoogle Scholar
  21. Nakamura S, Ito H, Nakamura K, Kuriyama S, Furu M, Matsuda S. Long-term durability of ceramic tri-condylar knee implants: a minimum 15-year follow-up. J Arthroplast. 2017;32(6):1874–9.CrossRefGoogle Scholar
  22. Parvataneni HK, Shah VP, Howard H, Cole N, Ranawat AS, Ranawat CS. Controlling pain after total hip and knee arthroplasty using a multimodal protocol with local periarticular injections: a prospective randomized study. J Arthroplast. 2007;22(6 Suppl 2):33–8.CrossRefGoogle Scholar
  23. Petterson SC, Mizner RL, Stevens JE, et al. Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Care Res. 2009;61(2):174–83.CrossRefGoogle Scholar
  24. Pfitzner T, Perca C, Roth P. Unicompartmental vs total knee arthroplasty for medial osteoarthritis. Z Orthop Unfall. 2017;155(5):527–33.CrossRefGoogle Scholar
  25. Pinskerova V, Samuelson KM, Stammers J, Maruthainar K, Sosna A, Freeman MA. The knee in full flexion: an anatomical study. J Bone Joint Surg. 2009;91(6):830–4.CrossRefGoogle Scholar
  26. Pitta M, Esposito DCI, Li DZ, Lee MDY, Wright TM, Padgett DE. Failure after modern total knee arthroplasty: a prospective study of 18,065 knees. J Arthroplast. 2018;33(2):407–14.CrossRefGoogle Scholar
  27. Pozzi F, Snyder-Mackler L, Zeni J. Physical exercise after knee arthroplasty: a systematic review of controlled trials. Eur J Phys Rehabil Med. 2013;49(6):877.PubMedPubMedCentralGoogle Scholar
  28. Pradhan NR, Gambhir A, Porter ML. Survivorship analysis of 3234 primary knee arthroplasties implanted over a 26 year period. Knee. 2006;13:7–11.CrossRefGoogle Scholar
  29. Pritchett JW. Bicruciate-retaining total knee replacement provides a satisfactory function and implant survivorship at 23 years. Clin Orthop Relat Res. 2015;473(7):2327–33.CrossRefPubMedPubMedCentralGoogle Scholar
  30. Ritter MA, Lutgring JD, Davis KE, Berend ME. The effect of postoperative range of motion on functional activities after posterior cruciate-retaining total knee arthroplasty. JBJS. 2008;90(4):777–84.CrossRefGoogle Scholar
  31. Rodriguez JA, Bhende H, Ranawat CS. Total condylar knee replacement: a 20-year followup study. Clin Orthop Relat Res. 2001;388:10–7.CrossRefGoogle Scholar
  32. Romagnoli S, Marullo M, Massaro M, Rustemi E, D’Amario F, Corbella M. Bi-unicompartmental and combined uni plus patellofemoral replacement: indications and surgical technique. Joints. 2015;3(1):42–8.PubMedPubMedCentralGoogle Scholar
  33. Rowell SL, Reyes CR, Malchau H, Muratoglu OK. In vivo oxidative stability changes of highly cross-linked polyethylene bearings: an ex vivo investigation. J Arthroplast. 2015;30(10):1828–34.CrossRefGoogle Scholar
  34. Rutherford RW, Jennings JM, Dennis DA. Enhancing recovery after Total knee arthroplasty. Orthop Clin North Am. 2017;48(4):391–400.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Salter RB, Simmonds DF, Malcolm BW, Rumble EJ, MacMichael D, Clements ND. The biological effect of continuous passive motion on the healing of full-thickness defects in articular cartilage. An experimental investigation in the rabbit. J Bone Joint Surg Am. 1980;62(8):1232–51.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Sartawi M, Zurakowski D, Rosenberg A. Implant survivorship and complication rates after total knee arthroplasty with a third-generation cemented system: 15-year follow-up. Am J Orthop (Belle Mead, NJ). 2018;47(3).  https://doi.org/10.12788/ajo.2018.0018
  37. Scott CEH, Bell KR, Ng RT, MacDonald DJ, Patton JT, Burnett R. Excellent 10-year patient-reported outcomes and survival in a single-radius, cruciate-retaining total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2019;27(4):1106–15.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Scuderi G. The impact of smart tools on total knee arthroplasty. Am J Orthop (Belle Mead NJ). 2007;36(9 Suppl):8–10.Google Scholar
  39. Srinivasan P, Miller MA, Verdonschot N, Mann KA, Janssen D. Strain shielding in trabecular bone at the tibial cement-bone interface. J Mech Behav Biomed Mater. 2017;66:181–6.CrossRefPubMedPubMedCentralGoogle Scholar
  40. Takasaki H, Okubo Y, Okuyama S. The effect of proprioceptive neuromuscular facilitation on joint position sense: a systematic review. J Sport Rehabil. 2019:1–30.  https://doi.org/10.1123/jsr.2018-0498
  41. Tarabichi S, Tarabichi Y, Hawari M. Achieving deep flexion after primary total knee arthroplasty. J Arthroplast. 2010;25(2):219–24.CrossRefGoogle Scholar
  42. Vince KG, Kelly MA, Beck J, Insall JN. Continuous passive motion after total knee arthroplasty. J Arthroplast. 1987;2(4):281–4.CrossRefGoogle Scholar
  43. Von Eiff MC, von Eiff W, Roth A, Ghanem M. Process optimization in total knee arthroplasty procedures: impact of size-specific instrument sets on costs and revenue. Orthopade. 2019;48(11):963–8.Google Scholar
  44. Wautier D, Thienpont E. Changes in anteroposterior stability and proprioception after different types of knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2017;25(6):1792–800.CrossRefGoogle Scholar
  45. Wilson CJ, Theodoulou A, Damarell RA, Krishnan J. Knee instability as the primary cause of failure following Total knee arthroplasty (TKA): a systematic review on the patient, surgical and implant characteristics of revised TKA patients. Knee. 2017;24(6):1271–81.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

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

Personalised recommendations