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Total knee arthroplasty (TKA) continues to grow in number each year with over three million procedures anticipated to be performed by 2030. The success and prevalence of the procedure has led to expansion in the types of implants available for surgeons to choose from. Shifts in biomaterials, bearing surfaces, and porous surfaces have occurred recently. It is difficult to find a source to make heads or tails of the available options and what they mean for patient outcomes and satisfaction. This instructional course lecture is focused on helping surgeons decide what to make of all the options available for the modern TKA.