Arthroplasty of the Knee With Tibial Metallic Implants of the McKeever and MacIntosh Design

Arthroplasty of the knee with tibial and/or femoral metallic implants in rheumatoid arthritis. Rheumatologic evaluation

“…Recently, interposition arthroplasties have been most popular, especially those utilizing metallic tibial plateau implants tailored after that proposed by MacIntosh in 1958 (2) or that reported for McKeever by Elliott in 1962 (3). Potter, using these devices, has recently reported good to excellent results in 56% of 142 arthroplasties evaluated 1 to 9 years after surgery (4). Ninety-five of 119 patients in this series fulfilled "the accepted criteria for rheumatoid arthritis.…”

Knee Arthroplasty in Rheumatoid Arthritis: An Analysis of 240 Cases of Hemi-, Hinge and Resurfacing Arthroplasties

“…Mcintosh arthroplasty in the Lund material resulted in 23 knees (34 %) with "satisfactory" and 44 (66 %) with "not satisfactory" results, using the Weinfeld point system at followup after an observation period of, on average, 3.3 years. On the basis of 10 published materials (Andersson et cl , 1973, Blum et ol , 1974, Conaty 1974, Hastings and Hewitson 1973, Mcintosh and Hunter 1972, Jani and Morscher 1973, Jessop and Moor 1972, Neville and M.artins 1972, Potter 1969, and Schorn et al 1977) the frequency of good or excellent results in a total of 553 knees in patients with rheumatoid arthritis can be calculated at 57 % (38-82 %) with average observation periods of 1.6-4.0 years. To compare different populations with different evaluation systems is of doubtful value, however (Andersson 1972).…”

“…• Subluxation of the tibia was considered a contraindication by Jani and Morscher (1973), Mcintosh (1971) and Potter (1969). In the Lund material, up to 30 0 of valgus or varus on weight-bearing was accepted.…”

“…These changes in the femoral condyles mainly developed after the arthroplasty and were believed to be caused by the articulation between an unelastic metal surface and abnormal cartilage at the femoral condyles. Potter (1969) found large subchondral cysts to be a contraindication. In the Lund material, an unsatisfactory result was found in 6 of 7 knees with large subchondral cysts in the tibia at operation.…”

“…The highest frequency of patellectomy was found in Murray's material (1967), 10 patellectomies in 20 arthroplasties. Keever (1959) re,commended patella prosthesis, Potter (1969) recommended fascia lata plasty. In the Lund material, only osteophytes were removed and erosions scraped.…”