الفهرس 
Surgical Anatomy of the kneeOnly 14 pages are availabe for public view
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Abstract
Summary
Total knee arthroplasty has proven to be successful and durable solution in the treatment of patients with end-stage degenerative disorders. With many implant designs and levels of constraint, selecting the optimum implant can be a difficult process.
Three broad types of TKA are used in uncomplicated primary TKA today: cruciate-retaining, cruciate-substituting, and mobile-bearing knees. For more complex reconstructions in which instability due to ligament failure is present, non-linked constrained arthroplasties have been used. (Linked constrained devices such as hinges are rarely used or even indicated). Unicompartmental TKA can be used in unicompartmental arthritis after careful patient selection. In the best designed of each category, long-term results are excellent in terms of fixation, function, pain scores, and motion.
*deformity = coronal and sagittal plane deformity.
Fig. 4-1: shows a suggested algorithm for choice of prosthesis according to the underlying disease and clinical findings. However, this can be changed according to surgeon training and preference. (74)
Regarding methods of fixation, cemented TKR should be the gold standard against which alternative fixation techniques are compared. A well-designed cemented prosthesis, implanted with meticulous surgical technique, has proven to be predictable and durable with excellent long-term results.
Recent reports with up to 10-year clinical follow-up have demonstrated that cementless total knee arthroplasty can yield excellent results in young, active patients when sound implant design principles and surgical techniques are followed.
Review of literature would suggest that no single option for patellar treatment in TKA, i.e. Patellar resurfacing versus unresurfacing, is presently clearly superior. Both options have potential advantages and drawbacks that surgeons may wish to integrate into their practice according to their training and experience, to patients’ values and expectations. Also, preoperative analysis of patellofemoral tracking, and intraoperative analysis of the patellofemoral articular surface and articulation are critical to the final decision. With optimal implant design and appropriate surgical techniques, optimal outcomes can be obtained for TKA with and without patellar resurfacing.