The difficult primary total knee arthroplasty

Abstract

Primary total knee arthroplasty has been proved to be an effective treatment of knee arthritis. As surgical techniques and implant design have evolved, the indications for primary total knee arthroplasty have expanded to include more complex cases. Surgical exposure may be difficult, and outcomes may not be as successful in patients with large deformities, severe knee stiffness, or posttraumatic arthritis. Moreover, special consideration and planning should be undertaken for patients with cardiovascular disease, obesity, inflammatory arthritis, Charcot arthropathy, or other comorbidities. Therefore, it is important for orthopaedic surgeons to be familiar with general principles that may help reduce the incidence of complications while also improving outcomes after total knee arthroplasty.