This article is more than 5 years old. Information may no longer be current.
‘Orthopedic triad’ essential to the success of mobile bearing knee systems
Patient factors, design and material manufacturing choices and surgical variables are all critical.
|
|
In the interest of assuring the functionality and longevity of mobile bearing knee systems, physicians should focus on an “orthopedic triad” composed of patient factors, design and material manufacturing choices, and surgical variables.
A. Seth Greenwald, DPhil (Oxon), a member of the Orthopedics Today Editorial Board, presented this triad to an audience during the presidential guest lecture at the British Orthopaedic Association Annual Congress 2009 in Manchester, United Kingdom.
Greenwald said he was honored to be the BOA 2009 presidential guest and was happy for the opportunity to offer his opinions on current and future total knee design.
The orthopedic triad
Greenwald presented his perspective on the tripartite factors, likening their relationship to a three-legged stool — no one leg can be effective without the other two.
“The continuing interest in the evolution of both fixed and mobile plateaus is manifest in an appreciation of their clinical outcome,” Greenwald said. “The above-stated triad clearly influences the short-, intermediate- and long-term patient outcomes,” he added.
Patient factors include knowing and understanding the patient and his or her needs. Design and material manufacturing choices are a matter of using the proper materials for maximum durability for the case at hand.
Greenwald said the most important leg of the triad are surgical variables, which include the technical proficiency of the operating surgeon.
Greenwald told Orthopedics Today that the triad was the take-home point of his address.
“The whole idea is to gain an assurance of clinical longevity,” he said.
His presentation included extensive laboratory and computational evaluation of total knee designs in relation to surgical proficiency and ultimate clinical performance.
High flexion’s place
Greenwald also spoke about how high flexion knee devices have influenced implant use globally. “The need for high flexion is increasingly recognized in the countries of the Middle East and Asia, where kneeling is a standard way of life that Americans do not practice,” he said. Concerns of material durability at high flexion angles can compromise device survivorship if frequently encountered, particularly in the young, active patient population.
His remarks provided an overview of contemporary evaluative techniques and clinical outcomes contributing to knee design optimization.
For more information:
- A. Seth Greenwald, DPhil (Oxon), director, Orthopaedic Research Laboratories, can be reached at 2310 Superior Ave., East, Cleveland, OH 44114; 216-523-7004; e-mail: seth@orl-inc.com.
Reference:
- Greenwald SA. The evolution and evaluation of contemporary total knee design. Presidential guest lecture. Presented at the British Orthopaedic Association Annual Congress 2009. Sept. 15-18. Manchester.