The evolution of knee arthroplasty. Results with three generations of prostheses.

One hundred sixty total knee arthroplasties using the Walldius (90), geometric (31), and total condylar (39) prostheses were analyzed by standardized ratings. Patients with total condylar knees had the highest mean postoperative rating, although the patients with Walldius knees derived the greatest symptomatic relief from surgery. There were 12 failures. Varus placement of the prosthesis occurred in 11 patients; eight of these knees were symptomatic. There were six wound infections, five of which were salvaged. The unsolved problems of total knee arthroplasties are: malalignment, loosening, infection, wear, and balancing mobility with stability.