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Modern Trends in Total Knee Arthroplasty

Diana J Zhu and Ran Schwarzkopf

Knee arthritis is a common disease that causes pain and disability. Non-surgical treatments include NSAIDs, lowimpact exercise, physical therapy, ambulatory assist devices and intra-articular injections. When these treatments fail to alleviate pain and restore knee function, such as in severe cases of knee osteoarthritis, total knee arthroplasty (TKA) may be necessary. Modern TKA has evolved significantly from its first incarnation and success rates are high. Various types of implants have the potential to allow more knee flexion and improved range of motion, but current studies show high-flexion devices do not conclusively improve function. Computer-assisted navigation during surgery allows greater accuracy in alignment, but may not ultimately improve survival rate or function. Complications during TKA surgery can involve infection, pain, and blood loss; intra-articular tranexamic acid can be used to decrease blood loss, while wound drains may increase blood loss. TKA patients under regional anesthesia appear to have fewer complications than patients under general endotracheal anesthesia.