The aim of this paper is to address some controversy in total knee arthroplasty.

 

Material and Methods: Scopus was searched in February 27, 2011. Articles published in Portuguese and English after 2008 were included, with some exceptions when considered very relevant to the subject in matter. The scientific quality of these articles was guaranteed by the international prestige of the journals that formed.

 

Results: The changes in total knee arthroplasty aimed to reduce the length of stay, to reduce postoperative complications, improve function, increase the bending and ensure the longevity of components. Based on some options that need to be taken by the orthopedist to achieve these goals, some aspects were discussed such as ways of approach, minimally invasive surgery vs classical surgery, materials used in components, fixation with cement vs. cementless, mobile platforms vs. fixed, sacrifice or not of the posterior cruciate ligament, design for high mobility and alignment of components.

 

Conclusion: Currently, there are some recommendations on the way of approach, method of impactation and it ́s impregnation, reduced blood loss and computer-assisted navigation in selected cases. Some of these aspects are still subjective, therefore, more studies are necessary in order to standardize procedures and to confirm results.

 

 

Key words: Arthroplasties, Replacement, Knee, Surgery, Prostheses, Design, Polyethylene.