Hungerford D S, Krackow K A
Clin Orthop Relat Res. 1985 Jan-Feb(192):23-33.
The total knee experience at a hospital in Baltimore with the Universal Instruments and Total Condylar and Kinematic prostheses in 1978 and 1979, and with the PCA prosthesis with and without cement since 1980, has led to the development of the philosophy that impacts on all aspects of total knee arthroplasty. In most instances, if the patient is a suitable risk for surgery and symptoms are sufficiently disabling to justify knee fusion, the authors would first attempt a total knee arthroplasty regardless of age, weight, or other factors. Technical perfection of alignment and component position are their goals. The vast majority of total knee components can be mechanically fixed rigidly without the addition of methylmethacrylate. In general, clinical examinations (up to four years) suggest that the cementless results were equally as good as the cemented results and did not have a tendency to deteriorate with time.
1978年和1979年，巴尔的摩一家医院使用通用器械、全髁和运动型假体进行全膝关节置换的经验，以及自1980年以来使用有骨水泥和无骨水泥的PCA假体的经验，促成了一种影响全膝关节置换术各个方面的理念的发展。在大多数情况下，如果患者适合手术且症状严重到足以证明膝关节融合合理，作者会首先尝试全膝关节置换术，而不考虑年龄、体重或其他因素。他们的目标是实现对线和假体位置的技术完美。绝大多数全膝关节组件无需添加甲基丙烯酸甲酯即可机械固定牢固。一般来说，临床检查（长达四年）表明，无骨水泥的结果与有骨水泥的结果同样好，且没有随时间恶化的趋势。
