Experience with the Sheehan knee replacement.

UNTIL recent years, patients with osteoarthritis and rheumatoid arthritis had little hope of effective treatment for their painful knees, whereas operations had been developed which could relieve pain in the hip. Arthroplasty of the hip is a standard operation with predictable results. Patients have unfortunately, though not surprisingly, come to expect a similar solution for their arthritic knees-and will be unwilling even to consider an arthrodesis. Although still in the stage of development considerable progress has been made, improving designs reflecting increasing understanding of the functional characteristics of the knee. Knee arthroplasty, using metal on plastic joints, was commenced on a trial basis at the Withers Orthopaedic Centre in 1974. The results of the first four years, using the Marmor and Geomedic knee replacements, were earlier reported by Lowry, McLeod and Mollan.' From late 1977, and especially in the more severely affected knees, the Sheehan prosthesis was used. This paper reports the results after adequate follow-up and discusses their implications.