Mould Arthroplasty of the Knee

Many forms of knee arthroplasty have been described but all are based on one of two principles. The first requires the interposition of material between the bony surfaces after removal of synovial membrane and articular cartilage ; in the second the knee joint is resected and replaced by a metal hinge (Walldius 1957, Shiers 1960). Material interposed between the bony surfaces has included chromicised pig’s bladder (Baer 1918), fascia lata (Putti 1920), skin (Brown, McGaw and Shaw 1958), nylon (Kuhns and Potter 1950) and Vitallium (Campbell 1940). Such materials often had serious disadvantages: chromicised pig’s bladder was not tolerated by the tissues, and fascia lata, skin and nylon wore away after a short time. Hinge arthroplasty can work well but resection of the knee joint results in undesirable shortening of the limb if for any reason the prosthesis must be removed for subsequent arthrodesis.