KNEO posterior-stabilized implant for TKA: Universal surgical instruments for all knee surgeons

Background: Successful total knee arthroplasty (TKA) depends on the synergy between implant design and surgical instrumentation. While many systems dictate a specific operative philosophy, there is a clinical need for versatile instrumentation that accommodates diverse surgical preferences, including varying alignment strategies and referencing methods, to address complex primary cases and revisions.

Objective: This article describes the design rationale, technical specifications, and surgical application of the KNEO posterior-stabilized, fixed-bearing total knee prosthesis and its associated universal instrumentation system.

Key Points: The KNEO system features 11 femoral and tibial sizes with asymmetric anatomical tibial components to optimize cortical coverage and rotational positioning. The instrumentation is modular, supporting both intramedullary and extramedullary alignment, as well as measured resection or gap-balancing techniques. Key surgical steps include a distal femoral cut adjustable from -2mm to +5mm, four distinct configurations for the proximal tibial resection, and a 4-in-1 femoral cutting block that allows for anterior or posterior referencing. The system incorporates multifunctional "multitools" to streamline the surgical tray. Preparation of the intercondylar box is performed using the trial implant, facilitating intraoperative assessment of patellar tracking and kinematics prior to final component fixation.

Conclusion: The KNEO system provides a flexible surgical platform that allows practitioners to maintain their preferred operative philosophy. By integrating universal instruments compatible with multiple alignment and referencing strategies, the system aims to simplify the technical execution of TKA while accommodating anthropomorphic variations and complex joint deformities.