Prakash Knee Paradigm Though total knee replacement is one of the most rewarding surgeries in modern orthopaedics, a small but significant number of patients remain dissatisfied after the surgery. The figures in the literature vary from 20% to 9%. If we exclude surgical complications like infection, periprosthetic fractures, component malalignment or inappropriate sizing, we are still left with 5 to 9% patients who are dissatisfied with the surgery, as not having met with their expectations. This despite a perfect X-ray and nothing wrong shown on clinical examination or tests, brings forth a serious question, which has often been asked on these and other fora.
How to choose a patient profile to avoid an unsatisfactory outcome? How to measure the outcome of surgery? After examining a large number of patients operated both by me and others, and those awaiting or offered alternative…
