Primary Knee Symposium: Biomechanical Considerations in the Knee

Conventional Instrumentation – Steven F. Harwin, MD

Dr. Harwin reviewed the failure modes for TKR. PSlide A He pointed out that it is unclear as to whether restoring the mechanical axis leads to better survivorship and longevity. He cited Parratte's study of 398 modern TKA's which showed that reproducing the mechanical axis did not improve survivorship at 15-years.¹

Dr. Harwin asserts that the way to avoid failures is through:

• Pre-operative planning
• Well designed, ergonomic, intuitive instruments
  • Based upon previous successful instrument systems
  • Accurate and reproducible
• Meticulous surgical technique
  • Used in combination with the "Cerebral Navigation System"
  • The surgeon must be skilled with conventional instruments even if navigation is preferred.
• Choosing the right implant
• Choosing the right fixation
  • Cement
  • PA coating

He discussed his results with the Triathlon System to emphasize these points. PSlide B PSlide C His summary points are outlined in PSlide D.

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