Total knee arthroplasty. A personal retrospective and prospective review.

The author's current concepts of total knee arthroplasty evolved from the design and subsequent 20 years' experience with a metallic tibial plate in more than 170 knees between 1953 and 1972. The rationale for this resurfacing device and, later on, for the development of the author's total knee replacement ensemble was based on certain basic principles that were directed to the preservation of bone stock and the reconstitution of the normal knee joint modalities. Sixteen subsequent years of personal experience in the implantation of more than 1700 total knee replacements commencing in 1972, using both cemented and uncemented fixation technique, have clearly established the direct relationship between the successful results and the degree of precision in the implementation of correct anatomic principles.