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⫸ What progress has been made in polyethylene? Answer - Crosslinking
⫸ What type of radius did the traditional knee design have? What is it now? Answer - Multi,
Single
⫸ What causes failures of TKA? Answer - infection
polyethylene wear
instability/malalignment
Aseptic loosening
Design issues
⫸ What is the #1 reason TKAs fail? Answer - polyethylene wear
⫸ What did Dr. Charnley combine to make a plastic that worked with the femoral head? Answer
- polyethylene and bone cement
⫸ Dr. Insall advanced the functional approach with what? What did he remove? Answer - Total
Condylar
Both cruciate ligaments
⫸ What issues were found in 1st generation designs? Answer - Aligning 4 components
Accurate instruments
Wear
, Soft tissue balancing
Sizing
Function and stability
Deformity
Fixation/loosening
⫸ What was a significant breakthrough? Answer - Porous Coated Anatomic
New universal instrumentation
⫸ What are some positive aspects the PS? Answer - Easier too align without fighting with
diseased PCL
Consistent femoral roll back
Greater sense of stability
Prevented excessive rotation
⫸ What does the CR do? Answer - only saves PCL
⫸ What does PS do? Answer - Removes ACL and PCL
⫸ Pros of PS Knee. Answer - deformities are more reliably corrected
⫸ Cons of PS Knee. Answer - PCL excised
More bone resection
Loss of proprioception
⫸ Pros of CR Knees. Answer - PCL is saved
Saves bone
Greater flexion
Good rollback
Posterior stability
Better PFJ function