Total joint arthroplasty of the knee.

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.