The evloution of total knee and hip joint arthroplasty

Eun-Kyoo Song; Jong-Keun Seon; Kyoung-Soon Park; Taek-Rim Yoon

doi:10.5124/jkma.2011.54.3.313

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Song, Seon, Park, and Yoon: The evloution of total knee and hip joint arthroplasty

Continuing Education Column

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2011; 54(3): 313-324.

Published online: 16 March 2011

DOI: https://doi.org/10.5124/jkma.2011.54.3.313

The evloution of total knee and hip joint arthroplasty

Eun-Kyoo Song, MD, Jong-Keun Seon, MD, Kyoung-Soon Park, MD, Taek-Rim Yoon, MD

Department of Orthopedic Surgery, Chonnam National Univeristy Hwasun Hospital, Hwasun, Korea.

Corresponding author: Jong-Keun Seon, eksong@chonnam.ac.kr

Received 15 December 2010 Accepted 5 January 2011

(open-access):

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Total joint arthroplasty, History, Development

Figures and Tables

Figure 1

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

Figure 2

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

Figure 3

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

Figure 4

Unicompartmental knee system (B: Courtesy of Zimmer).

Figure 5

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

Figure 6

Ceramic on polyethylene articulation.

Figure 7

Metasul metal on metal articulation.

Figure 8

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

Figure 9

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

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