Despite modern advancements, total knee arthroplasty (TKA) is still far from perfection. With its dissatisfaction, which is 20-25%, the concept of TKA needs to be improved. TKA satisfaction is... Show moreDespite modern advancements, total knee arthroplasty (TKA) is still far from perfection. With its dissatisfaction, which is 20-25%, the concept of TKA needs to be improved. TKA satisfaction is associated with patient factors, surgical factors, and postoperative complications. Patient factors have an important role in TKA satisfaction, and one of that is to obtain good implant-bone fit are crucial in patient factors. It depends on patient’s ethnicities, socio-economic, and cultural. Therefore, special consideration is needed in Asian patients. Most TKA system, which is based on North American and European patients, could not be matched with Asian patients. Smaller sizes should be available to have a good implant-bone fit. But even with the TKA systems that were available, Asian patients had more significant improvement in range of motion compared to North American patients. It might be due to preoperative conditions and surgical factors. In the surgical factors, patellar denervation and accelerometer-based navigation were introduced. Patellar denervation failed to decrease AKP, while accelerometer-based navigation was also unable to show its superiority in improving functional outcomes. Therefore, the surgeon should decide at what point in the evolution of this emerging technology that the potential benefits of computer-assisted methods justify the costs and potential risks in an individual practice. In postoperative complications, VTE is one of the major complications. The racial may influence VTE risk. Hence, a different approach might be needed in VTE prevention for Asian patients. In the end, TKA remains a compromise to nature. Show less
