Techniques for managing anatomic variations in primary total knee arthroplasty

Abstract

Primary total knee arthroplasties have high success rates, but certain patient anatomic or other variations may adversely affect the performance or the clinical outcomes of these procedures. Various technologies and techniques have been developed in attempts to overcome these challenges. However, there is controversy concerning whether these innovations are beneficial. This article assessed the scientific evidence regarding the use of these technologies to address various anatomic variations by examining the complete body of literature. The anatomic variations that were examined included extra-articular deformities, bone deficiencies, ligamentous instability, post-patellectomy knees, patella baja, variations in bone size and high-flexion knees. Recommendations for each circumstance were presented based upon the available scientific evidence.

Keywords::

• arthroplasty
• bone deficiency
• bone size
• constrained implant
• extra-articular deformity
• high-flexion knee
• knee
• patella baja
• patellectomy
• technology

Financial & competing interests disclosure

MA Mont is a consultant for Stryker and Wright Medical Technologies. PM Bonutti is a consultant for Stryker. The other authors have no potential conflicts of interest. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.