Total Knee Arthroplasty Design and Kinematics: Past, Present, and Future

Total knee arthroplasty has undergone significant improvement in design and clinical application over the past 45 years. Unfortunately, 15-20% of patients are not satisfied with their result. While the explanation for this discrepancy is multifactorial, prosthetic design and the motion of the knee in space has come under greater scrutiny. The early designs attempted to copy the anatomic appearance of the knee joint without considering how the knee would move. Kinematics is now considered to be of paramount importance and may be the key to the future of knee arthroplasty.