National joint registry data, patient-reported outcome measures, and considerable revisionsurgeries demonstrate the need for scalable quality improvements in care surrounding total kneearthroplasty (TKA). While TKA is the primary treatment for end-stage knee osteoarthritis,substantial postoperative complications still eclipse overall success – despite many recentadvances in materials, technology, and infection control. For uncomplicated primary TKA,implant selection hinges initially on the integrity of the cruciate ligament(s), but ultimately lieswith surgeon personal preference. Given many of the factors influencing TKA outcomes areunmodifiable or difficult to standardize, implant design offers a unique target for improvement.As TKA designs have evolved, notable functional improvements or deficits have been associatedwith various implant features, such as patellar clunk in the early posterior-stabilized (PS) devices.Contemporary surgical practice is beginning to move away from the post-cam mechanisms of PSknees, and relying increasingly more on conforming insert geometry and/or native cruciateligaments for stability. In the present work, we evaluate the effects of modern TKA design onfunctional outcomes, and investigate temporal TKA knee kinematics through a combination ofclinical and computational studies.
展开▼
