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Why is it harder to design and perform a knee replacement than a hip replacement?

A knee replacement, called a total knee arthroplasty is more complicated than a hip replacement, or arthroplasty. The hip bone is a ball and socket type of joint, but the knee joint is more complicated.

The implant for the knee has to be able to withstand the force on the knee, as well as the ligaments and muscles pulling from three different directions.

Reference: 

Jess H. Lonner, MD, and Carl A. Deirmengian, MD. What's New in Adult Reconstructive Knee Surgery. In The Journal of Bone and Joint Surgery. December 2007. Vol. 89-A. Pp. 2828-2837.

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