Die knietotalendoprothese differenzialindikation und ergebnisse

osteoarthritis the appropriate prosthesis design, fixation method and degree of constraint have to be decided preoperatively. In general three types of constraint are distinguished: unconstrained, semi-constrained and linked-constrained. In knees with no complex deformity or need for difficult ligament balancing an unconstrained design can be chosen. Cruciate- retaining and cruciate-substituting prostheses are both associated with certain advantages and disadvantages but according to the current literature neither technique is superior. Mobile bearings are hypothesized to reduce wear and forces applied across the knee but no clear clinical benefit has been observed. If adequate stability in the coronal plane cannot be achieved a semi-constrained prosthesis with stem fixation should be used. Among (semi-) constrained designs prostheses with a rotating platform show significantly better results with regard to aseptic loosening and revision rates. Routine resurfacing of the patella seems to be beneficial when using posterior stabilized prostheses. Most studies show superior results for cemented or hybrid fixation compared to cementless prostheses.