Experiences with three distinct types of total knee joint arthroplasty.

Experience with three different designs of total knee systems indicates that generally excellent knee function can be afforded the majority of patients for many years. The identification of patients who presently cannot expect satisfactory long-term function (the young, muscular, or obese, yet otherwise normal, individual, for instance) and their exclusion as candidates is important for long-term success. The importance of postoperative limb alignment and component position is emphasized. Gross instability and great metaphyseal bone loss are identified as the indications for linked, primary, or revision total knee arthroplasty. The role of the dynamic behavior of trabecular bone is hypothesized to be of major importance in long-term prosthetic knee joint function.