The evloution of total knee and hip joint arthroplasty

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.