Total Knee Arthroplasty (TKA) consists of resection of the diseased articular surfaces of the knee, followed by resurfacing with metal and polyethylene prosthetic components. 

Despite the potential benefits of TKA, TKA is usually performed on an elective basis and should only be considered after exhaustion of appropriate nonsurgical therapies and extensive discussion of the risks, benefits, and alternatives.

INDICATIONS FOR FIXED BEARING

Candidates for total knee replacement include patients with a severely painful and/or severely disabled joint resulting from:

  • Osteoarthritis
  • Post-traumatic arthritis 
  • Rheumatoid arthritis
  • A failed previous implant.

CONTRAINDICATIONS FOR FIXED BEARING

The following conditions are contraindications for total knee replacement:

  • Active local or systemic infection.
  • Loss of bone or musculature, osteoporosis, neuromuscular compromise or vascular deficiency in the affected limb in sufficient degree to render the procedure unjustifiable (e.g., absence of musculoligamentous supporting structures, joint neuropathy).
  • Severe instability secondary to advanced loss of osteochondral structure or the absence of collateral ligament integrity.

INDICATIONS FOR ROTATING PLATFORM (RP)

The Rotating Platform (RP) Total Knee System is indicated for cemented use in cases of osteoarthritis and rheumatoid arthritis. The rotating platform prosthesis is indicated for primary total knee arthroplasty or the revision of failed knee prostheses. The CR RP device configuration is indicated for use in knees whose posterior cruciate ligament is intact, absent, or in such condition as to justify its sacrifice.

CONTRAINDICATIONS FOR ROTATING PLATFORM (RP)

The use of the RP Total Knee System is contraindicated in:

  • The presence of osteomyelitis, pyrogenic infection or other overt infection of the knee joint. Every effort should be made to rule out the possibility of preoperative sepsis in a patient who has one or more of the following abnormalities: 
    • Fever or local inflammation
    • Rapid destruction or bone resorption apparent on x-rays
    • Elevation of the erythrocyte sedimentation rate or white blood cell count unexplained by other disease or a marked shift in the white blood cell differential count. 
  • Patients with any active infection at sites such as the genitourinary tract, pulmonary system, skin or any other site. Should a patient have any infection prior to implantation, the foci of the infection must be treated prior to, during and after implantation. 
  • Patients with loss of musculature or neuromuscular compromise leading to loss of function in the involved limb or in whom the requirements for its use would affect recommended rehabilitation procedures.
  • Patients with severe osteoporosis or other metabolic bone diseases of the knee
  • Patients with any of the following conditions: 
    • Lesions of the supporting bone structures (e.g. aneurysmal or simple bone cysts, giant cell tumor or any malignant tumor)
    • Systemic and metabolic disorders leading to progressive deterioration of solid bone support 
    • The presence of severe instability secondary to advanced loss of osteochondral structure or the absence of collateral ligament integrity, fixed deformities greater than 60° of flexion, 45° of genu varus or valgus.
    • Known drug or alcohol addiction
    • Skeletally immature individuals and the presence of allergic reaction to implant metals or polyethylene are also contraindications for the use of all device configurations of the RP Total Knee System.

       

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