Revision Total Knee Arthroplasty

The two previously published Classic Articles included in this issue have an interesting relationship to each other and to the Classic written by Dr. Dorr and his co-authors. The paper by Frank Gunston describes the first modern total knee replacement which conceptually addressed the issue of the shifting center of rotation. The narrow runners and tracks he devised, however, sank into the soft bone of the proximal tibia and most of these failed rather soon after implantation. The polycentric prosthesis therefore provided orthopaedic surgeons with some of their earliest challenges in revision arthroplasty. Dr. Otto Aufranc worked with Dr. Smith-Petersen during the years of the ascendancy of the cup arthroplasty and consequently he had little experience with total joints. His Classic Article is a kind of farewell to surgery with a caution to surgeons to do everything possible to prevent infections which, as it turns out, was good advice, since infection is one of the major complications leading to the need for a revision.