For a brief overview of knee anatomy, physiology, and biomechanics, please click here.

What's New in Adult Reconstructive Knee Surgery, Michael J. Archibeck et al.; Journal of Bone and Joint Surgery (American Edition), December 2004, Volume 87, pages 1656-1666. Comments: This superb article provides a comprehensive review of all the options available to a knee with advanced osteoarthritis. The authors discuss numerous previous studies, and look at both unicompartmental (one-side-only) and bicompartmental (i.e. both sides, hence total) knee replacements. They also examine potential complications and concerns which could arise from these types of major knee surgery, including infection, patellofemoral issues, deep vein thrombosis, and prosthetic wear/longevity.

Minimally Invasive Total Knee Arthroplasty , Peter M. Bonutti, Michael A. Mont et al.; Journal of Bone and Joint Surgery (American), December 2004, Volume 86, pages 25-32. Comments: This article, complete with full-colour photographs of in-progress knee surgeries, shows in detail how a total knee prosthesis is installed with a minimum of incisions. (Note that TKR/TKA typically involves the removal of substantial amounts of bone and other structures in the knee, and thus qualifies as a drastic procedure by any standard. So, any modification to the procedure which makes it less drastic is especially desirable from the patient's viewpoint.) The authors describe a surgical technique (the lateral approach) aimed at making rehabilitation less painful for patients. By going through the iliotibial band, the procedure avoids invading the quadriceps (extension) musculature. Also, there is no need to dislocate the knee when removing the bone in preparation for prosthesis installation.

Proprioception, Kinesthesia, and Balance After Total Knee Arthroplasty with Cruciate-Retaining and Posterior Stabilized Prostheses , C. Buz Swanik et al.; Journal of Bone and Joint Surgery (American), February 2004, Volume 86, pages 328-334. Comments: This study shows that there is less difference than one might anticipate between cruciate-retaining and posterior stabilized types of knee prostheses. The installation of many types of knee prostheses typically includes the removal of one or both cruciate ligaments. Intuitively, however, one might except that keeping both of the cruciate ligaments would be prefereable. This study focused specifically on the effect of conserving the posterior cruciate ligament, and it found that saving the PCL did not bring a significant benefit with regards to proprioception. (If both the ACL and the PCL were conserved, then perhaps a more substantial benefit might be realized.)

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