What's New in Adult Reconstructive Knee Surgery
Michael J. Archibeck, MD; Richard E. White Jr., MD

The purpose of this update on adult reconstructive knee surgery is to discuss, in summary fashion, topics presented at selected orthopaedic meetings and published in related orthopaedic journals between January and December 2001. The sources for this review are articles published in The Journal of Bone and Joint Surgery (American edition) and The Journal of Arthroplasty . The podium presentations mentioned in this article include those given at the annual meeting of the American Academy of Orthopaedic Surgeons (held in San Francisco, California, on February 28 through March 4, 2001), on Specialty Day at the meeting of The Knee Society (held in San Francisco, California, on March 3, 2001), and at the meeting of The American Association of Hip and Knee Surgeons (held in Dallas, Texas, on November 9 through 11, 2001). The Interim Meeting of the Knee Society was cancelled as a result of the events of September 11, 2001.

Surgical Treatment of Osteoarthritis Without Arthroplasty

While total knee replacement has been very successful for alleviating pain and improving function in patients of all ages, surgical treatments other than arthroplasty remain an option for some patients. Mosely et al., in a randomized, double-blind, placebo-controlled trial of arthroscopic treatment of osteoarthritis of the knee in 180 patients with two years of follow-up, found equal improvement in the three treatment groups (débridement, lavage, and placebo arthroscopy), suggesting that the improvement was secondary to a placebo effect. However, Fond et al. reported that 69% (twenty-five) of thirty-six patients who underwent arthroscopic notchplasty and débridement for osteoarthritis of the knee had a good or excellent result at five years. Mandelbaum, in a four-year, multicenter study of more than 1300 patients who underwent autologous chondrocyte implantation in the knee, reported clinical improvement in 70% of patients, with the best results occurring in patients with femoral lesions (85% of whom had …

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