Abstract
Total knee arthroplasty causes unresolved pain and swelling in about 10% of patients despite good alignment, ligament balance, and fixation. Metal sensitivity becomes more common in total knee patients as time passes, wear continues to be a clinically relevant issue, loosening increases in frequency with time, and infection continues to plague implant surgery. Ceramic bearing surfaces address all of these issues. New technologies make possible stronger, more flexible ceramic materials, and one ceramic in particular (magnesia-stabilised zirconia) is especially interesting because of its ability to accept a commercially pure titanium porous coating. These materials do not release metal debris or ions, wear is reduced by a factor of three, and biofilm formation is reduced by a factor of three or more when compared with cobalt-chromium.
After clearing regulatory requirements, this new ceramic technology is likely to advance our solutions to many of the most important clinical problems in knee arthroplasty.
