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Review article: Biomedical intelligence

Vol. 145 No. 0708 (2015)

Arthroplasty – current strategies for the management of knee osteoarthritis

  • Sufian S Ahmad
  • Benjamin Gantenbein
  • Dimitrios S Evangelopoulos
  • Michael O. Schär
  • Stefan Schwienbacher
  • Hendrick Kohlhof
  • Sandro Kohl
DOI
https://doi.org/10.4414/smw.2015.14096
Cite this as:
Swiss Med Wkly. 2015;145:w14096
Published
08.02.2015

Summary

Osteoarthritis of the knee is a major clinical burden. Recent decades have witnessed an improved understanding of knee physiology and kinematics, which has led to the introduction of a wide range of enhanced prosthetic implant designs for a variety of indications. However, the increase in the number of procedures performed annually has led to complications being encountered at higher rates than ever before, requiring the development of optimised therapeutic strategies. The future holds several promising options, primarily in the treatment of early osteoarthritis, biological therapy, surgical navigation and patient-specific implants. This review provides an insight into the current options of knee arthroplasty, with emphasis on available designs, and examines the complications that may be encountered.

References

  1. Nuki G. Osteoarthritis: a problem of joint failure. Z Rheumatol. 1999;58(3):142–7.
  2. Peat GM, Moores L, Goldingay S, Hunter M. Pain management program follow-ups. a national survey of current practice in the United Kingdom. J Pain Symptom Manage. 2001;21(3):218–26.
  3. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis. 2001;60(2):91–7.
  4. Felson DT. Clinical practice. Osteoarthritis of the knee. N Engl J Med. 2006;354(8):841–8.
  5. Hunter DJ, Felson DT. Osteoarthritis. BMJ. 2006;332(7542):639–42.
  6. Gordon-Taylor G. Sir William Fergusson, 1808–1877. Medical history. 1961;5:1–14.
  7. Ranawat CS. History of total knee replacement. J South Orthop Assoc. 2002;11(4):218–26.
  8. Amendola L, Tigani D, Fosco M, Dallari D. History of Condylar Total Knee Arthroplasty. In: Fokter S, editor. Recent Advances in Hip and Knee Arthroplasty. Rijeka: InTech; 2012.
  9. Williams D, Garbuz D, Masri B. Total knee arthroplasty: Techniques and results. BC Medical Journal. 2010;52(9):447–54.
  10. Gunston FH. Polycentric knee arthroplasty. Prosthetic simulation of normal knee movement. J Bone Joint Surg Br. 1971;53(2):272–7.
  11. Mancuso CA, Ranawat CS, Esdaile JM, Johanson NA, Charlson ME. Indications for total hip and total knee arthroplasties. Results of orthopaedic surveys. J Arthroplasty. 1996;11(1):34–46.
  12. Hawker GA, Wright JG, Coyte PC, Williams JI, Harvey B, Glazier R, et al. Determining the need for hip and knee arthroplasty: the role of clinical severity and patients’ preferences. Medical Care. 2001;39(3):206–16.
  13. Diduch DR, Insall JN, Scott WN, Scuderi GR, Font-Rodriguez D. Total knee replacement in young, active patients. Long-term follow-up and functional outcome. J Bone Joint Surg Am. 1997;79(4):575–82.
  14. Davies AP, Vince AS, Shepstone L, Donell ST, Glasgow MM. The radiologic prevalence of patellofemoral osteoarthritis. Clin Orthop Relat Res. 2002(402):206–12.
  15. Fulkerson JP. Alternatives to patellofemoral arthroplasty. Clin Orthop Relat Res. 2005(436):76–80.
  16. Saleh KJ, Arendt EA, Eldridge J, Fulkerson JP, Minas T, Mulhall KJ. Symposium. Operative treatment of patellofemoral arthritis. J Bone Joint Surg Am. 2005;87(3):659–71.
  17. Leadbetter WB. Patellofemoral arthroplasty in the treatment of patellofemoral arthritis: rationale and outcomes in younger patients. Orthop Clin North Am. 2008;39(3):363–80, vii.
  18. Leadbetter WB, Seyler TM, Ragland PS, Mont MA. Indications, contraindications, and pitfalls of patellofemoral arthroplasty. J Bone Joint Surg Am. 2006;88(Suppl 4):122–37.
  19. Lubinus HH. Patella glide bearing total replacement. Orthopedics. 1979;2(2):119–27.
  20. Blazina ME, Fox JM, Del Pizzo W, Broukhim B, Ivey FM. Patellofemoral replacement. Clin Orthop Relat Res. 1979(144):98–102.
  21. Ackroyd CE, Chir B. Development and early results of a new patellofemoral arthroplasty. Clin Orthop Relat Res. 2005(436):7–13.
  22. Odumenya M, McGuinness K, Achten J, Parsons N, Spalding T, Costa M. The Warwick patellofemoral arthroplasty trial: a randomised clinical trial of total knee arthroplasty versus patellofemoral arthroplasty in patients with severe arthritis of the patellofemoral joint. BMC Musculoskelet Disord. 2011;12:265.
  23. Scott RD, Santore RF. Unicondylar unicompartmental replacement for osteoarthritis of the knee. J Bone Joint Surg Am. 1981;63(4):536–44.
  24. Tinius M, Hepp P, Becker R. Combined unicompartmental knee arthroplasty and anterior cruciate ligament reconstruction. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA. 2012;20(1):81–7.
  25. Berger RA, Nedeff DD, Barden RM, Sheinkop MM, Jacobs JJ, Rosenberg AG, et al. Unicompartmental knee arthroplasty. Clinical experience at 6– to 10–year followup. Clin Orthop Relat Res. 1999(367):50–60.
  26. Ashraf T, Newman JH, Evans RL, Ackroyd CE. Lateral unicompartmental knee replacement survivorship and clinical experience over 21 years. J Bone Joint Surg Br. 2002;84(8):1126–30.
  27. Berend KR, Lombardi AV, Jr., Morris MJ, Hurst JM, Kavolus JJ. Does preoperative patellofemoral joint state affect medial unicompartmental arthroplasty survival? Orthopedics. 2011;34(9):e494–6.
  28. Hauptmann SM, Kreul U, Mazoochian F, C VS-P, Jansson V, Muller PE. [Influence of patellofemoral osteoarthritis on functional outcome after unicondylar knee arthroplasty]. Der Orthopade. 2005;34(11):1088, 90–3.
  29. Beard DJ, Pandit H, Ostlere S, Jenkins C, Dodd CA, Murray DW. Pre-operative clinical and radiological assessment of the patellofemoral joint in unicompartmental knee replacement and its influence on outcome. J Bone Joint Surg Br. 2007;89(12):1602–7.
  30. Suero EM, Citak M, Cross MB, Bosscher MR, Ranawat AS, Pearle AD. Effects of tibial slope changes in the stability of fixed bearing medial unicompartmental arthroplasty in anterior cruciate ligament deficient knees. The Knee. 2012;19(4):365–9.
  31. Argenson JN, Parratte S. The unicompartmental knee: design and technical considerations in minimizing wear. Clin Orthop Relat Res. 2006;452:137–42.
  32. Hernigou P, Deschamps G. Alignment influences wear in the knee after medial unicompartmental arthroplasty. Clin Orthop Relat Res. 2004(423):161–5.
  33. Bruni D, Gagliardi M, Akkawi I, Raspugli GF, Bignozzi S, Marko T, et al. Good survivorship of all-polyethylene tibial component UKA at long-term follow-up. Knee Surg Sports Traumatol Arthrosc. 2014.
  34. Schlueter-Brust K, Kugland K, Stein G, Henckel J, Christ H, Eysel P, et al. Ten year survivorship after cemented and uncemented medial Uniglide(R) unicompartmental knee arthroplasties. Knee. 2014;21(5):964–70.
  35. Insall JN, Hood RW, Flawn LB, Sullivan DJ. The total condylar knee prosthesis in gonarthrosis. A five to nine-year follow-up of the first one hundred consecutive replacements. J Bone Joint Surg Am. 1983;65(5):619–28.
  36. Insall JN, Kelly M. The total condylar prosthesis. Clin Orthop Relat Res. 1986(205):43–8.
  37. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780–5.
  38. Banks SA, Markovich GD, Hodge WA. In vivo kinematics of cruciate-retaining and -substituting knee arthroplasties. J Arthroplasty. 1997;12(3):297–304.
  39. Jacobs WC, Clement DJ, Wymenga AB. Retention versus removal of the posterior cruciate ligament in total knee replacement: a systematic literature review within the Cochrane framework. Acta Orthop. 2005;76(6):757–68.
  40. Buechel FF, Pappas MJ, DePalma AF. “Floating-socket” total shoulder replacement: anatomical, biomechanical, and surgical rationale. J Biomed Mater Res. 1978;12(1):89–114.
  41. Goodfellow J, O’Connor J. The mechanics of the knee and prosthesis design. J Bone Joint Surg Br. 1978;60–b(3):358–69.
  42. van der Voort P, Pijls BG, Nouta KA, Valstar ER, Jacobs WC, Nelissen RG. A systematic review and meta-regression of mobile-bearing versus fixed-bearing total knee replacement in 41 studies. Bone Joint J. 2013;95–b(9):1209–16.
  43. Argenson JN, Scuderi GR, Komistek RD, Scott WN, Kelly MA, Aubaniac JM. In vivo kinematic evaluation and design considerations related to high flexion in total knee arthroplasty. J Biomech. 2005;38(2):277–84.
  44. Delp SL, Kocmond JH, Stern SH. Tradeoffs between motion and stability in posterior substituting knee arthroplasty design. J Biomech. 1995;28(10):1155–66.
  45. McCalden RW, MacDonald SJ, Bourne RB, Marr JT. A randomized controlled trial comparing “high-flex” vs “standard” posterior cruciate substituting polyethylene tibial inserts in total knee arthroplasty. J Arthroplasty. 2009;24(6 Suppl):33–8.
  46. Barrett WP. The need for gender-specific prostheses in TKA: does size make a difference? Orthopedics. 2006;29(9 Suppl):S53–5.
  47. Booth RE, Jr. Sex and the total knee: gender-sensitive designs. Orthopedics. 2006;29(9):836–8.
  48. Hitt K, Shurman JR, 2nd, Greene K, McCarthy J, Moskal J, Hoeman T, et al. Anthropometric measurements of the human knee: correlation to the sizing of current knee arthroplasty systems. J Bone Joint Surg Am. 2003;85–A Suppl 4:115–22.
  49. Ho WP, Cheng CK, Liau JJ. Morphometrical measurements of resected surface of femurs in Chinese knees: correlation to the sizing of current femoral implants. Knee. 2006;13(1):12–4.
  50. Karlson EW, Daltroy LH, Liang MH, Eaton HE, Katz JN. Gender differences in patient preferences may underlie differential utilization of elective surgery. Am J Med. 1997;102(6):524–30.
  51. Greene KA. Gender-specific design in total knee arthroplasty. J Arthroplasty. 2007;22(7 Suppl 3):27–31.
  52. Girard J, Amzallag M, Pasquier G, Mulliez A, Brosset T, Gougeon F, et al. Total knee arthroplasty in valgus knees: predictive preoperative parameters influencing a constrained design selection. Orthop Traumatol Surg Res. 2009;95(4):260–6.
  53. Ranawat AS, Ranawat CS, Elkus M, Rasquinha VJ, Rossi R, Babhulkar S. Total knee arthroplasty for severe valgus deformity. J Bone Joint Surg Am. 2005;87(Suppl 1)(Pt 2):271–84.
  54. Rossi R, Rosso F, Cottino U, Dettoni F, Bonasia DE, Bruzzone M. Total knee arthroplasty in the valgus knee. Int Orthop. 2014;38(2):273–83.
  55. Pang HN, Yeo SJ, Chong HC, Chin PL, Chia SL, Lo NN. Joint line changes and outcomes in constrained versus unconstrained total knee arthroplasty for the type II valgus knee. Knee Surg Sports Traumatol Arthrosc. 2013;21(10):2363–9.
  56. Cameron HU, Hunter GA. Failure in total knee arthroplasty: mechanisms, revisions, and results. Clin Orthop Relat Res. 1982(170):141–6.
  57. Ritter MA, Davis KE, Farris A, Keating EM, Faris PM. The Surgeon’s Role in Relative Success of PCL-Retaining and PCL-Substituting Total Knee Arthroplasty. HSSJ. 2014;10(2):107–15.
  58. Naudie DD, Rorabeck CH. Managing instability in total knee arthroplasty with constrained and linked implants. Instr Course Lect. 2004;53:207–15.
  59. Vasso M, Beaufils P, Schiavone Panni A. Constraint choice in revision knee arthroplasty. Int Orthop. 2013;37(7):1279–84.
  60. Morgan H, Battista V, Leopold SS. Constraint in primary total knee arthroplasty. J Am Acad Orthop Surg. 2005;13(8):515–24.
  61. Lachiewicz PF, Soileau ES. Results of a second-generation constrained condylar prosthesis in primary total knee arthroplasty. J Arthroplasty. 2011;26(8):1228–31.
  62. Radnay CS, Scuderi GR. Management of bone loss: augments, cones, offset stems. Clin Orthop Relat Res. 2006;446:83–92.
  63. Meijer MF, Reininga IH, Boerboom AL, Stevens M, Bulstra SK. Poorer survival after a primary implant during revision total knee arthroplasty. Int Orthop. 2013;37(3):415–9.
  64. Yang JH, Yoon JR, Oh CH, Kim TS. Primary total knee arthroplasty using rotating-hinge prosthesis in severely affected knees. Knee Surg Sports Traumatol Arthrosc. 2012;20(3):517–23.
  65. Wernecke GC, Harris IA, Houang MT, Seeto BG, Chen DB, MacDessi SJ. Comparison of tibial bone coverage of 6 knee prostheses: a magnetic resonance imaging study with controlled rotation. J Orthop Surg. (Hong Kong). 2012;20(2):143–7.
  66. Luyckx L, Luyckx T, Bellemans J, Victor J. Iliotibial band traction syndrome in guided motion TKA. A new clinical entity after TKA. Acta Orthop Belg. 2010;76(4):507–12.
  67. Cherian JJ, Kapadia BH, Banerjee S, Jauregui JJ, Harwin SF, Mont MA. Bicruciate-retaining total knee arthroplasty: a review. J Knee Surg. 2014;27(3):199–205.
  68. Tibesku CO, Innocenti B, Wong P, Salehi A, Labey L. Can CT-based patient-matched instrumentation achieve consistent rotational alignment in knee arthroplasty? Arch Orthop Trauma Surg. 2012;132(2):171–7.
  69. Chockalingam S, Scott G. The outcome of cemented vs. cementless fixation of a femoral component in total knee replacement (TKR) with the identification of radiological signs for the prediction of failure. Knee. 2000;7(4):233–8.
  70. Rorabeck CH, Bourne RB, Nott L. The cemented kinematic-II and the non-cemented porous-coated anatomic prostheses for total knee replacement. A prospective evaluation. J Bone Joint Surg Am. 1988;70(4):483–90.
  71. Lutz MJ, Halliday BR. Survey of current cementing techniques in total knee replacement. ANZ J Surg. 2002;72(6):437–9.
  72. Barrack RL, Wolfe MW, Waldman DA, Milicic M, Bertot AJ, Myers L. Resurfacing of the patella in total knee arthroplasty. A prospective, randomized, double-blind study. J Bone Joint Surg Am. 1997;79(8):1121–31.
  73. Mayman D, Bourne RB, Rorabeck CH, Vaz M, Kramer J. Resurfacing versus not resurfacing the patella in total knee arthroplasty: 8– to 10–year results. J Arthroplasty. 2003;18(5):541–5.
  74. Pilling RW, Moulder E, Allgar V, Messner J, Sun Z, Mohsen A. Patellar resurfacing in primary total knee replacement: a meta-analysis. J Bone Joint Surg Am. 2012;94(24):2270–8.
  75. Mason JB, Fehring TK, Estok R, Banel D, Fahrbach K. Meta-analysis of alignment outcomes in computer-assisted total knee arthroplasty surgery. J Arthroplasty. 2007;22(8):1097–106.
  76. Nunley RM, Ellison BS, Zhu J, Ruh EL, Howell SM, Barrack RL. Do patient-specific guides improve coronal alignment in total knee arthroplasty? Clin Orthop Relat Res. 2012;470(3):895–902.
  77. Sparmann M, Wolke B, Czupalla H, Banzer D, Zink A. Positioning of total knee arthroplasty with and without navigation support. A prospective, randomised study. J Bone Joint Surg Br. 2003;85(6):830–5.
  78. Koskinen E, Eskelinen A, Paavolainen P, Pulkkinen P, Remes V. Comparison of survival and cost-effectiveness between unicondylar arthroplasty and total knee arthroplasty in patients with primary osteoarthritis: a follow-up study of 50,493 knee replacements from the Finnish Arthroplasty Register. Acta Orthop. 2008;79(4):499–507.
  79. Lustig S, Scholes CJ, Oussedik SI, Kinzel V, Coolican MR, Parker DA. Unsatisfactory accuracy as determined by computer navigation of VISIONAIRE patient-specific instrumentation for total knee arthroplasty. J Arthroplasty. 2013;28(3):469–73.
  80. Boonen B, Schotanus MG, Kort NP. Preliminary experience with the patient-specific templating total knee arthroplasty. Acta Orthop. 2012;83(4):387–93.
  81. Bulstrode C. Total hip replacement: the way forward. Ann R Coll Surg Engl. 1996;78(2):129–32.
  82. Kolling C, Simmen BR, Labek G, Goldhahn J. Key factors for a successful National Arthroplasty Register. J Bone Joint Surg Br. 2007;89(12):1567–73.
  83. Havelin LI, Robertsson O, Fenstad AM, Overgaard S, Garellick G, Furnes O. A Scandinavian experience of register collaboration: the Nordic Arthroplasty Register Association (NARA). J Bone Joint Surg Am. 2011;93(Suppl 3):13–9.
  84. Swedish Knee Arthroplasty Register. Annual Report 20122012 [cited 1 May 2013]. Available from: http://www.knee.nko.se/english/online/uploadedFiles/117_SKAR_2012_Engl_1.0.pdf.
  85. Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L. Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand. 2000;71(3):262–7.
  86. Kane RL, Saleh KJ, Wilt TJ, Bershadsky B. The functional outcomes of total knee arthroplasty. J Bone Joint Surg Am. 2005;87(8):1719–24.
  87. Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not? Clin Orthop Relat Res. 2010;468(1):57–63.
  88. Robertsson O, Dunbar MJ. Patient satisfaction compared with general health and disease-specific questionnaires in knee arthroplasty patients. J Arthroplasty. 2001;16(4):476–82.
  89. Piscitelli P, Iolascon G, Innocenti M, Civinini R, Rubinacci A, Muratore M, et al. Painful prosthesis: approaching the patient with persistent pain following total hip and knee arthroplasty. Clinical cases in mineral and bone metabolism: the official journal of the Italian Society of Osteoporosis, Mineral Metabolism, and Skeletal Diseases. 2013;10(2):97–110.
  90. Clarke HD, Scott WN. Knee: axial instability. Orthop Clin North Am. 2001;32(4):627–37, viii.
  91. Fehring TK, Valadie AL. Knee instability after total knee arthroplasty. Clin Orthop Relat Res. 1994(299):157–62.
  92. Lonner JH, Siliski JM, Scott RD. Prodromes of failure in total knee arthroplasty. J Arthroplasty. 1999;14(4):488–92.
  93. Gupta SK, Chu A, Ranawat AS, Slamin J, Ranawat CS. Osteolysis after total knee arthroplasty. J Arthroplasty. 2007;22(6):787–99.
  94. Fennema P, Heyse TJ, Uyl-de Groot CA. Cost-effectiveness and clinical implications of advanced bearings in total knee arthroplasty: a long-term modeling analysis. Int J Technol Assess Health Care. 2014;30(2):218–25.
  95. Vince KG, Abdeen A, Sugimori T. The unstable total knee arthroplasty: causes and cures. J Arthroplasty. 2006;21(4 Suppl 1):44–9.
  96. Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med. 2004;351(16):1645–54.
  97. Ahmad SS, Huber K, Evangelopoulos DS, Kleer B, Kohlhof H, Schar M, et al. The cement prosthesis-like spacer: an intermediate halt on the road to healing. ScientificWorldJournal. 2013;2013:763434.
  98. Darouiche RO. Treatment of infections associated with surgical implants. N Engl J Med. 2004;350(14):1422–9.
  99. Romano CL, Gala L, Logoluso N, Romano D, Drago L. Two-stage revision of septic knee prosthesis with articulating knee spacers yields better infection eradication rate than one-stage or two-stage revision with static spacers. Knee Surg Sports Traumatol Arthrosc. 2012;20(12):2445–53.
  100. Werner FW, Ayers DC, Maletsky LP, Rullkoetter PJ. The effect of valgus/varus malalignment on load distribution in total knee replacements. J Biomech. 2005;38(2):349–55.
  101. Aglietti P, Buzzi R, Gaudenzi A. Patellofemoral functional results and complications with the posterior stabilized total condylar knee prosthesis. J Arthroplasty. 1988;3(1):17–25.
  102. Clayton ML, Thirupathi R. Patellar complications after total condylar arthroplasty. Clin Orthop Relat Res. 1982(170):152–5.
  103. Huo MH, Sculco TP. Complications in primary total knee arthroplasty. Orthopaedic review. 1990;19(9):781–8.
  104. Lynch AF, Rorabeck CH, Bourne RB. Extensor mechanism complications following total knee arthroplasty. J Arthroplasty. 1987;2(2):135–40.
  105. Webster DA, Murray DG. Complications of Variable Axis total knee arthroplasty. Clin Orthop Relat Res. 1985(193):160–7.
  106. Mihalko WM, Krackow KA. Flexion and extension gap balancing in revision total knee arthroplasty. Clin Orthop Relat Res. 2006;446:121–6.
  107. Alden KJ, Duncan WH, Trousdale RT, Pagnano MW, Haidukewych GJ. Intraoperative fracture during primary total knee arthroplasty. Clin Orthop Relat Res.2010;468(1):90–5.
  108. Culp RW, Schmidt RG, Hanks G, Mak A, Esterhai JL, Jr., Heppenstall RB. Supracondylar fracture of the femur following prosthetic knee arthroplasty. Clin Orthop Relat Res. 1987(222):212–22.
  109. Delport PH, Van Audekercke R, Martens M, Mulier JC. Conservative treatment of ipsilateral supracondylar femoral fracture after total knee arthroplasty. J Trauma. 1984;24(9):846–9.
  110. Figgie MP, Goldberg VM, Figgie HE, 3rd, Sobel M. The results of treatment of supracondylar fracture above total knee arthroplasty. J Arthroplasty. 1990;5(3):267–76.
  111. Rorabeck CH, Taylor JW. Periprosthetic fractures of the femur complicating total knee arthroplasty. Orthop Clin North Am. 1999;30(2):265–77.
  112. McGraw P, Kumar A. Periprosthetic fractures of the femur after total knee arthroplasty. Journal of orthopaedics and traumatology: official journal of the Italian Society of Orthopaedics and Traumatology. 2010;11(3):135–41.
  113. Daluga D, Lombardi AV, Jr., Mallory TH, Vaughn BK. Knee manipulation following total knee arthroplasty. Analysis of prognostic variables. J Arthroplasty. 1991;6(2):119–28.
  114. Ritter MA. Postoperative pain after total knee arthroplasty. J Arthroplasty. 1997;12(3):337–9.
  115. Shoji H, Yoshino S, Komagamine M. Improved range of motion with the Y/S total knee arthroplasty system. Clin Orthop Relat Res. 1987(218):150–63.
  116. Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. Brit Med J open. 2012;2(1):e000435.
  117. Macrae WA. Chronic post-surgical pain: 10 years on. Br J Anaesth. 2008;101(1):77–86.
  118. Katz MM, Hungerford DS, Krackow KA, Lennox DW. Reflex sympathetic dystrophy as a cause of poor results after total knee arthroplasty. J Arthroplasty. 1986;1(2):117–24.
  119. Hallab N, Merritt K, Jacobs JJ. Metal sensitivity in patients with orthopaedic implants. J Bone Joint Surg Am. 2001;83–A(3):428–36.
  120. Granchi D, Cenni E, Tigani D, Trisolino G, Baldini N, Giunti A. Sensitivity to implant materials in patients with total knee arthroplasties. Biomaterials. 2008;29(10):1494–500.
  121. DesJardins JD, Burnikel B, LaBerge M. UHMWPE wear against roughened oxidized zirconium and CoCr femoral knee components during force-controlled simulation. Wear. 2008;264(3–4):245–56.
  122. Lee JK, Maruthainar K, Wardle N, Haddad F, Blunn GW. Increased force simulator wear testing of a zirconium oxide total knee arthroplasty. Knee. 2009;16(4):269–74.
  123. Tsukada S, Wakui M, Matsueda M. Metal block augmentation for bone defects of the medial tibia during primary total knee arthroplasty. J Orthop Surg Res. 2013;8:36.