The future of knee arthroplasty

Dear Sir, Total knee arthroplasty (TKA) represents the gold standard for the definitive treatment of advanced osteoarthritis of the knee. However, despite the good or excellent results that many of these implants have demonstrated throughout the years in terms of survivorship and surgeon satisfaction, a discrepancy still exists between the objective scores and the personal satisfaction of the patients. The solutions proposed by both manufacturers and surgeons to reduce this discrepancy have focussed on a reconsideration of the entire procedure, including improvement in surgical technique and instrumentation, more anatomical designs that allow more natural kinematics, and post-operative care. As expected, these theoretical improvements still need the proof of time. Meanwhile, new problems have arisen. In the past ten years the concept of minimally invasive TKA has been introduced into current practice with variable results.1-3 After an initial great enthusiasm, different publications showed poor results while a large number of complications persuaded many surgeons to desist and to return to more classical …