Abstract
Total knee arthroplasty has become a highly successful joint reconstruction procedure. Surgical outcomes, patient satisfaction, and implant survival have improved steadily since its inception, and the operation has become widely accepted as a technique to afford relief of pain and to restore range of motion and function. In this review, I discuss the basic principles of the surgical technique for total knee arthroplasty, covering skin incision, surgical approaches to the knee, proper alignment, bone cutting, correct ligament balance for deformed knees, and postoperative complications such as postoperative infection and periprosthetic fractures. Several problems relating to total knee arthroplasty are also discussed. In primary total knee arthroplasty, the clinical results are influenced by the surgical technique. Adherence to the basic principles of the surgical technique ensures a successful outcome. The goal of primary total knee arthroplasty is to reestablish the normal mechanical axis with a stable prosthesis that is well fixed. Regardless of prosthetic design, there are three basic bone cuts in primary total knee arthroplasty: the proximal tibia, the distal femur, and the posterior femur. Each cut influences the arthroplasty in a different manner. Usually, the amount of bone resected corresponds to the thickness of the component being implanted.
