Editorial Comment

Total knee arthroplasty has been reported in many short-term and mid-term followup reports. As emphasized in this symposium, however, a minimum of 10-years followup is required before a claim of success may be made. Reviews with less than a 10-year followup often show no problems with the new design unless major flaws are identified. The articles in this symposium emphasize not only success of cement or cementless fixation but also the problems associated with polyethylene wear in modular components. Surgeons today must correlate the track record of the system they are implanting with long-term reports of other systems such as the total condylar knee replacement.

The Guest Editors and all the authors are privileged to dedicate this symposium to the late Dr. John Insall. It is through the pioneering efforts John made that tremendous strides have occurred in knee arthroplasty for which all of us have benefited. All of the designs to date are offshoots of his original total condylar knee replacement. Without people such as John Insall, total knee replacement would be very slow in progressing.