Meniscal-Bearing Knee Arthroplasty

  • Frederick F. Buechel


Human joint replacements have been developed with the specific bioengineering requirements to provide normal kinematics, maintain fixation and minimize wear. Lowering contact stresses to within the reported medical load limit of 5 MP (22) while allowing kinematically acceptable motion provides a meniscal bearing surface that is resistant to fatigue wear and has demonstrated normal abrasive wear behavior over a 20 year period as seen in both clinical, simulator, and retrieval studies, (17, 18, 27, 33, 44).


Total Knee Arthroplasty Cruciate Ligament Posterior Cruciate Ligament Knee Replacement Contact Stress 
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  1. 1.
    ) Bartel, D.L., Bicknell, V.L., Wright, T.M.: The effect of conformity, thickness, and material on stress in ultra-high molecular weight polyethylene components for total joint replacement. J. Bone Joint Surg., 68A: 1041–1051, 1986.Google Scholar
  2. 2.
    ) Bert, J.M.: Dislocation/subluxation of meniscal elements after New Jersey Low-Contact Stress total knee arthroplasty. Clin. Orthop. 254: 211–215, 1990.Google Scholar
  3. 3.
    ) Boume, R.B., Goodfellow, J.W., O’Connor, J.J.: A functional analysis of various knee arthroplasties. Transactions of the 24th Annual Meeting of The Orthopaedic Research Society, Dallas, Texas, 21–23, 1978, p. 156.Google Scholar
  4. 4.
    ) Buechel, F.F..: A simplified evaluation system for the rating of knee function. Orthop. Rev.: 97–101, 1982.Google Scholar
  5. 5.
    ) Buechel, F.F.: Cementless LCS endoprostheses: Concepts and 10 year evaluation. Presented at the 4th World Bio Materials Congress. Berlin, Germany, April 27,1992.Google Scholar
  6. 6.
    ) Buechel, F.F.: Cementless meniscal bearing TKA. Presented at the Eight Annual Current Concepts in Joint Replacement Symposium. Orlando, Florida, December 18, 1992.Google Scholar
  7. 7.
    ) Buechel, F.F.: Cementless mobile bearing TKR: 10 years results. Presented at the Seventh Annual Joint Replacement Symposium. Palm Beach, Florida, October 23, 1992.Google Scholar
  8. 8.
    ) Buechel, F.F.: Fourteen year survivorship analysis of mobile bearing total knee arthroplasties. Presented at The State of the Art in Total Joint Replacement Symposium. Phoenix, Arizona, November 24, 1992.Google Scholar
  9. 9.
    ) Buechel, F.F.: Letters to the Editor. Re: Dislocation/subluxation of the LCS Knee Replacement. Clin. Orthop. 264:309, 1991.Google Scholar
  10. 10.
    ) Buechel, F.F., Sorrels, B.: New Jersey LCS Milestone Surgical Procedure. Depuy Division of Boeringer Mannheim Corp., Warsaw, Indiana, 1995.Google Scholar
  11. 11.
    ) Buechel, F.F.: Patella tendon bone grafting for patellectomized patients undergoing knee replacement. Clin. Orthop. 271: 72–78, 1991.Google Scholar
  12. 12.
    ) Buechel, F.F.: Treatment of the patella in revision total knee surgery using a rotating-bearing patellar replacement. Orthop. Rev. Supp. 76–82, 1990.Google Scholar
  13. 13.
    ) Buechel, F.F., Keblish, P.K., Pappas, M.J., et al: New Jersey LCS Unicompartimental Knee replacement: clinical, radiographic, statistical and survivorship analyses of 106 cementless cases performed by 7 surgeons. Food and Drug Administration Panel Presentation. Rockville, Maryland, August 16, 1991.Google Scholar
  14. 14.
    ) Buechel, F.F. Pappas, M.J: Efficacy and application of modular Stem in THR. Presented at the Combined Meeting of the Orthopaedic Associations of the English Speaking World. Toronto, Canada, june 21–26, 1992. (Poster Exhibit)Google Scholar
  15. 15.
    ) Buechel, F.F., Pappas, M.J.: Long-term survivorship analyses of cruciate sparing versus cruciate sacrificing knee prostheses using meniscal bearings. Clin. Orthop. 260: 162–169, 1990.Google Scholar
  16. 16.
    ) Buechel, F.F., Pappas, M.J.: New Jersey integrated total knee replacement system: Biomechanical analysis and clinical evaluation of 918 cases. FDA Panel Presentation, Silver Spring, Maryland, July 11, 1984.Google Scholar
  17. 17.
    ) Buechel, F.F., Pappas, M.J.: New Jersey LCS Knee replacement system biomechanical rationale and comparison of cemented and non-cemented results (A two to five follow-up). Contemp. Orthop., 1984.Google Scholar
  18. 18.
    ) Buechel, F.F., Pappas, M.J.: New Jersy LCS Knee replacement system: 10 year evaluation of meniscal bearings. Orthop. Clinic N.A., 20: 147–177, 1989.Google Scholar
  19. 19.
    ) Buechel, F.F., Pappas, M.J.: New Jersey Meniscal Bearing Knee U.S. Patent No. 4,340,978, July 27, 1982.Google Scholar
  20. 20.
    ) Buechel, F.F., Pappas, M.J.: The New Jersey Low Contact Stress knee replacement system: Biomechanical rationale and review of the first 123 cemented cases. Arch. Orthop. Trauma Surg. 105:197–204, 1986.CrossRefGoogle Scholar
  21. 21.
    ) Buechel, F.F., Pappas, M.J., Greenwald, A.S.: Use of survivorship and contact stress analyses to predict the long term efficacy of new generation joint replacement designs: A model for FDA device evaluation. Orthop. Rev., 20: 50–55, 1991.Google Scholar
  22. 22.
    ) Buechel, F.F., Pappas, M.J., Makris, G.: Evaluation of contact stress in metal-backed patellar replacements: a predictor of survivorship. Clin. Orthop., 273: 190–197, 1991.Google Scholar
  23. 23.
    ) Buechel, F.F., Pappas, M.J., Peoples, S., Davenport, J.M., Friddle, N.M.: New Jersey LCS Posterior cruciate Retaining Total Knee Replacement: Clinical, radiographic, statistical, and survivorship analyses of 395 cementless cases performed by 13 surgeons. Food and Drug Administration Panel Presentation. Rockville, Maryland, June 1, 1990.Google Scholar
  24. 24.
    ) Buechel, F.F., Rosa, R.A., Pappas, M.J.: A metal-backed, rotating-bearing patellar prosthesis to lower contact stress: an 11 year clinical study. Clin. Orthop. 248: 34–49, 1989.Google Scholar
  25. 25.
    ) Buechel, F.F., Sorrels, B., Pappas, M.J.: New Jersey Rotating Platform total knee replacement: Clinical, radiographic, statistical, and survivorship analyses of 346 cases performed by 16 surgeons. Food and Drug Administration Panel Presentation. Gaithersburg, Maryland, November 22, 1991.Google Scholar
  26. 26.
    ) Coll, B.F., Jacquot, P.: Surface modification of medical implants and surgical devices using TiN Layers. Surface Coating Technology. 36:867–878, 1988.CrossRefGoogle Scholar
  27. 27.
    ) Can, A.J., Keyes, G., Miller, R.K.: Medial unicompartmental arthroplasty: A survival study of the Oxford Meniscal Knee. Presented at The Ninth Combined Meeting of the Orthopaedic Association of the English-speaking World. Toronto, Canada, June 21–26, 1992, (Poster Exhibit).Google Scholar
  28. 28.
    ) Collier, J.P., Mayor, M.B., Surprenant, B.A., et al. The Biomechanical problems of polyethylene as a bearing surface. Clin. Orthop. 261: 107–113, 1990.Google Scholar
  29. 29.
    ) Engh, G.A., Dwyer, D.A., Hanes, C.K.: Polyethylene wear of metal-backed tibial components in total and unicompartmental knee prosthesis. J.Bone Joint Surg. 74B: 9–17, 1992.Google Scholar
  30. 30.
    ) Ewald, F.C., Jacobs, M.A., Miegel, R.E., et al: Kinematic total knee replacement. J. Bone Surg. 66A: 1032, 1984.Google Scholar
  31. 31.
    ) Freeman, M.A.R., Railton, G.T.: Should the posterior cruciate ligament be retained or resected in condylar non-meniscal knee arthroplasty? The case for resection. J Arthrop., Suppl., 53–62, 1988.Google Scholar
  32. 32.
    ) Goodfellow, J.W., O’Connor, J.: Clinical Results of the Oxford Knee surface arthroplasty of the tibio-femoral joint with a meniscal bearing prostheses. Clin. Orthop. 205: 2142, 1986.Google Scholar
  33. 33.
    ) Goodfellow, J., O’Connor, J. The mechanics of the knee and prosthesis design. J Bone joint Surg. 60B: 358, 1978.Google Scholar
  34. 34.
    ) Hamelynck, K.: Results of 106 Cementless Bi-Cruciate Retaining meniscal bearing knee replacements in osteoarthritis. Personal Communication 1991.Google Scholar
  35. 35.
    ) Huang, C.H., Lee, Y.M., Su, R.Y., et al: Clinical results of the New Jersey Low Contact Stress knee arthroplasty with two to five years follow-up. J. Orthop. Surg. ROC 8:295303, 1991.Google Scholar
  36. 36.
    ) Huson, A., Spoor, C.W., Verbout, A.J.: A model of the human knee derived from Kinematic principles and its relevance for endoprosthesis design. Acta Morphal. Neerl. Scand. 270:45, 1989.Google Scholar
  37. 37.
    ) Keblish, P.A.: Patella retention vs. re-surfacing. Presented at The Issues in Orthopaedic Implant Technology Symposium Rancho Mirage, California. November 10–15, 1992.Google Scholar
  38. 38.
    ) Keblish, P.A., Greenwald, S.A.: Patella retention versus patella resurfacing in total knee arthroplasty. Presented at the 58th Annual Meeting of the American Academy of Orthopaedic Surgeons, March 7–12, 1991. (Scientific Exhibit).Google Scholar
  39. 39.
    ) Keblish, PA., Pappas, M.J.: Rationale and selection of prosthetic types in mobile bearing total knee arthroplasty. Presented at The 59th Annual American Academy of Orthopaedic Surgeons. Washington, D.C. February 20–25, 1992. (Scientific Exhibit).Google Scholar
  40. 40.
    ) Landy, M., Walker, P.A.: Wear in condylar replacement knees. A 10 year follow-up. Trans. Orthop. Res. Soc. 10:96, 1985.Google Scholar
  41. 41.
    ) Lombardi, A.V., Mallory, F.J., Vaughn, B.K., et al: the Total Condylar III prosthesis in complex primary total knee arthroplasty: A three to ten year clinical and radiograph evaluation. Presented at The combined Meeting of The Orthopaedic Associations of the English Speaking World.Google Scholar
  42. 42.
    ) Moran, C.G., Pinder, I.M., Lee, T.A., et al: Survivorship analysis of the uncemented porous coated Anatomic knee replacement. J. Bone Joint Surg. 73A: 848–857, 1991.Google Scholar
  43. 43.
    ) New Jersey Low contact Stress Posterior Cruciate Retaining Cementless Total knee Replacement Approval for United States Distrubution. Letter to Depuy, Warsaw, Indiana, from Food and Drug Administration, Rockville, Maryland, October 2, 1990.Google Scholar
  44. 44.
    ) O’Connor, J., Goodfellow, J., Biden, E.: Designing the human knee. In Stokes, I.A.F. (ed).: Mechanical Factors and the skeleton. London, John Libbey, 1981.Google Scholar
  45. 45.
    ) Oshner, J.L., Dorr. L.D., Gronley, J., at al.: Prospective Comparison of Posterior Cruciate-Retaining Versus Cruciate Sacrificed Total Knee Arthroplasty. Presented at the 55th Annual Meeting of The American Accademy of Orthopaedic Surgeons. Atlanta, Georgia, February 4–9, 1988.Google Scholar
  46. 46.
    ) Pappas, M.J., Makris, G., Buechel, F.F.: Biomaterials for hard tissue applications. In Pizzoferrato, A., Marchetti, P.G., Ravaglioli A., Lee, A.J.C. (eds): Biomaterials and Clinical Applications: Evaluation of Contact Stresses in Metal-Plastic Replacements. Amsterdam, Elsevier, 1987, pp. 259–264.Google Scholar
  47. 47.
    ) Peter, P.C., Engh, G.A., Dwyer, K.A.: Osteolysis after total knee arthroplasty without cement. J. Bone Joint Surg. 74A: 864–876, 1992.Google Scholar
  48. 48.
    ) Pillar, R.M., Cameron, J.U., Welsh, R.P., et al: Radiographic and morphologic studies of load-bearing porous-surfaced implants. Clin. Orthop. 156:249–57, 1981.Google Scholar
  49. 49.
    ) Ranawat, C.S., Flynn, W.F., Saddler, S., et al. Long-term results of the Total Condylar knee arthroplasty. A 15 year survivorship study. Presented at The Ninth Combined Meeting of The Orthopaedic Association.Google Scholar
  50. 50.
    ) Rose, R.M., M.D., Paul, I.L., et al: Wear of the tibial cornponent of the knee prosthesis. Transactions of the 28th annual Orthopaedic Research Society, New Orleans, Lousiana, January 19–21, 1982, Vol. 7p. 252.Google Scholar
  51. 51.
    ) Schatzer, J., Horne, J.G., Summer-Smith, G.: The effect of movement on the holding power of screws in bone. Clin. Orthop. III: 257–262, 1975.Google Scholar
  52. 52.
    ) Schlepckow, P.: Three dimensional Kinematics of total knee replacement system. Arch. Orthop. Trauma Surg. III: 204–209, 1992.Google Scholar
  53. 53.
    ) Scuderi, G.R., Insall, J.N., Windsor, R.E., et al: Survivorship of cemented knee replacements. J Bone Joint Surg. 71B:798–803, 1989.Google Scholar
  54. 54.
    Tria, A.J., Klein, K.S.: An illustrated guide to the Knee Biomechanics. Chapter,2001 2,pp.31–38 Churchill Livingstone, New York.Google Scholar
  55. 55.
    ) Nielsen, P.T., Hansen, E.B., and Rechnagel K.: Cementless total knee arthroplasty in unselected cases of osteoarthritis and rheumatoid arthritis: A 3 year folllow-up study of 103 cases. J. Arthrop., 7:137–143, 1992.CrossRefGoogle Scholar

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© Springer-Verlag Wien 2001

Authors and Affiliations

  • Frederick F. Buechel
    • 1
  1. 1.New Jersey Medical SchoolNew York

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