History of Total Knee Replacement

Abstract

“Arthroplasty of the knee has as yet, no standard technique. It is still an open chapter in joint surgery and one which offers much promise” (Albee 1928). F. H. Albee made this statement in 1928 in his description of an arthroplasty with “an improved prognosis”. His conclusion reflected (and still reflects to some degree) the frustrations associated with attempting effectively to replace one of the most complex joints in the body. As the joint in the body which is furthest removed both proximally and distally from the next adjacent articulation, it is subjected to major stresses. Deficiencies in mobility cannot be easily compensated for by the hip or the ankle. The incongruity of the opposing joint surfaces with the additional complexity of the patellofemoral articulation have presented a challenge for over a century to those surgeons attempting to provide relief from major disabilities involving the knee. For the most part, until the last fifteen years, these efforts have been characterized more by ingenuity than by success. Allison and Brooks in 1923 conceded that it was impossible to restore the normal gliding of the articular surfaces of the knee, either experimentally or in surgically reconstructed joints. This attitude of course did not dissuade the pioneers in the field from individually or collectively pursuing the “impossible”.