J Korean Med Assoc.  2011 Mar;54(3):313-324.

The evloution of total knee and hip joint arthroplasty

• Song EK
• Seon JK
• Park KS
• Yoon TR

Abstract

The evolution of total joint replacement is not merely of historical interest. We review the historic development of total joint arthroplasty to look at what has been selected and what has not selected in the past. For more than 30 years, total joint arthroplasty has been progressively developed to improve functional outcomes and survivorship. There has been debate regarding the presence of posterior cruciate ligament (cruciate retaining vs. posterior stabilized) and bearing articulation (fixed vs. mobile). Unicompartmental knee arthroplasty is used through minimally invasive surgery with relatively good results. Still, liner wear and limitation in the range of motion were concerns, prompting the development of highly cross-linked polyethylene and hyperflexion design prostheses. Although there have been a number of improvements in the design and concepts behind hip joint arthroplasty for many years, fixation methods and bearing surfaces are still in debate. Future developments in total joint arthroplasty should be focused on improved function, wear reduction, enhanced kinematics, and increased range of motion. We can look forward to further advancements in total joint arthro-plasty in the area of new materials and designs.

Keyword

Total joint arthroplasty; History; Development

MeSH Terms

Arthroplasty
Biomechanics
Hip
Hip Joint
Joints
Knee
Polyethylene
Posterior Cruciate Ligament
Prostheses and Implants
Range of Motion, Articular
Survival Rate
Ursidae
Polyethylene

Figure

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  Figure 1 Posterior-stabilized prosthesis showing that the post- and-cammechanism offers no restraint to varus or valgus stability.

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  Figure 2 Low contact stress prosthesis (Courtesy of Dr. DePuy).

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  Figure 3 The Legacy Constrained Condylar Knee prosthesis (Courtesy of Zimmer).

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  Figure 4 Unicompartmental knee system (B: Courtesy of Zimmer).

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  Figure 5 Moor hemiarthroplasty prosthesis. There is a long stem fenestrated to reduce its weight.

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  Figure 6 Ceramic on polyethylene articulation.

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  Figure 7 Metasul metal on metal articulation.

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  Figure 8 Ceraminc on ceramic articulation with composed of ceramic head and ceramic threaded cup.

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  Figure 9 Ceramic on ceramic articulation with metal cup, ceramic liner (Biolox Delta) and ceramic head (Biolox Forte).

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