Current total knee replacements solve the problem of arthritic knee joints, but the evidence is that normal patterns of knee motions are not restored (1) In addition; paradoxical anterior sliding of the femur on the tibia can occur in the first half of the flexion range (2). Achieving natural motion is likely to be important for daily activities which involve higher angles of flexion, in terms of restoring normal soft tissue lengths and patello-femoral mechanics. Studies have shown the damaging effects of anterior femoral slide on the tibia affecting both the patella and the patellar tendon (3). Our paper examines new knee replacement designs which incorporate geometrical features to regain anatomical knee motion.

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