Which Implant Do I Pick? Thoughtful Considerations

Our clinical decisions, including choice of prosthesis, are influenced by many factors. Nonetheless, we hope to justify them with thoughtful considerations. My personal practice, considering primary arthroplasty only, is composed of unicompartmental arthroplasty in 5%; fixed-bearing, metal-backed modular, cemented posterior stabilized prostheses modified for gender and high flexion considerations in approximately 85%; and nonlinked constrained devices in 9%. Hinged implants and patello-femoral replacements account for approximately 1%. Constrained devices provide options for unanticipated instability or poor bone quality in a minority of patients.