1) Computer Assisted Surgery (Computerized Navigation)
One of the important factors in the success of a knee replacement surgery is limb alignment achieved after surgery. This in turn is dependant making the bone cuts and placing the implants in the desired alignment. In conventional knee replacement surgery the bone cuts are guided by mechanical devices (jigs). It is widely reported in the literature that use of such jigs may result in an error of more than 5-9 % in the eventual limb alignment. Use of computerized navigation not only reduces this error to less than 3 % but also allows an “on table” assessment of the limb alignment during the surgery.
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2) Minimally invasive total knee replacement (MI TKR)
This refers to knee replacement surgery using a smaller incision (cut). The obvious advantage is a smaller scar and decreased tissue trauma which allows faster wound healing and return to function. It is a technically demanding procedure and requires specialized equipment. There is some concern about “limited visibility” to the operating surgeon due to the minimal access which may lead to knee replacement components being placed in less than optimum position which can affect the eventual outcome. At the present moment it is not a universally accepted and recommended technique.
3) Rotating platform and high flexion knee replacement
In the rotating platform design, the plastic liner between the femoral and tibial component is free to rotate on the smooth tibial platform allowing some rotational movement as in the normal knee. This is also thought to reduce the wearing out rate of the plastic liner and hence improve the longevity of the prosthesis. In the high flexion design, the femoral component is designed so as to allow greater degree of flexion in the knee (up to 155 degrees) thus allowing patients to squat or sit on the floor. There are some designs which have both these features combined in it.