Historical Overview
»For more than 100 years, surgeons have been doing knee replacements. The first surgical technique was interpositional arthroplasty, devised by Ferguson in the 1860s, in which damaged bone was removed from the articular surface and cushioning material was placed between the femur and tibia. This initial technique was later refined by using cushioning materials from the patient's own body: joint capsule, muscle, skin or fascia.
»Later, in the 1940s, following the lead of hip replacement surgery, surgeons began replacing parts of the knee joint itself. In hemiarthroplasty, one damaged bone surface, either the femur or the tibia, was replaced with a metal or plastic prosthesis.
»Finally, in the 1950s, Waldius developed total knee arthroplasty in which a hinged metal knee replaced the patient's own damaged bone. However, this first total knee replacement system proved unable to withstand everyday stresses and when the implant loosened, patients would experience pain. Refinements since that time have been in the areas of components, materials, bonding and the basic use of instruments, determining the joint's placement.
»In 1971, Gunston developed a total knee replacement that was the first to treat each compartment of the knee separately. It featured single unconnected metal rails that were used to replace each femoral condyle and the tibial surface then had a polyethylene track. This established the basis for the first unicompartmental reconstruction. This was followed by additional refinements throughout the '70s and '80s.
»In 1988, the M/G Unicompartmental Knee System was developed by Zimmer in conjunction with Jo Miller, M.D., Jorge Galante, M.D., and Gunnar Andersson, M.D. Numerous papers have been published.
»Minimally invasive unicompartmental knee arthroplasty is a relatively conservative surgical procedure. Less bone is removed from the affected condyle and its tibial platform, and only the affected compartment is treated. The 2- to 3-inch incision normally required results in a smaller scar for the patient. The conservative nature of the minimally invasive procedure offers the potential for a faster recovery time, greater range-of-motion than a total knee replacement, and leaves enough bone to accommodate a primary total knee prosthesis at a later date, if required.
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