Partial knee arthroplasty

Abstract

Total knee arthroplasty (TKA) continues to be a safe and effective surgical procedure for arthritis of the knee and is in fact the current gold standard for treatment [1, 2]. However, based on this author's experience of performing TKA for over 15 years, several observations are apparent. First, not all TKA patients are satisfied with their postoperative function. The work of Noble et al. [3] suggests that upwards of 50% of TKA patients describe some form of functional deficit, particularly during side-to-side movement. Such outcomes highlight the necessity of the anteriorcruciate ligament (ACL) and its important role in functional satisfaction subsequent to TKA. The second observation is that the ACL and the posterior-cruciate ligament (PCL) are often times healthy and undamaged at the time of the surgery. It is unsettling to realize that contemporary surgical techniques required the undue resection of these structures. The final observation is the previously documented combination of wear of the medial and patellofemoral joint (PFJ) compartments, coupled with a non-symptomatic lateral compartment [4]. Resection of the entire articular surface is a further example of the unnecessary sacrifice of healthy tissue.