"Knee replacement is bound to fail-providing the patient lives long
enough." There is some truth in this hoary cliche, so why write
books on the subject? I think the answer is that knee replacement
has at last become established and even respectable. The more
absurd surgical extravaganzas have been recognised and discarded;
today a patient can expect to rely on his new knee to serve him
with comfort for a fair number of years. Of course even the early
knee replacements often made the patient comfortable; the trouble
was they just did not last. All too often the innovator's
enthusiasm was overtaken by the patient's disillusionment. Indeed,
the operation might well have been abandoned had it not been for
the hope that one day the dazzling results at the hip might be
matched at the knee. These pioneer prostheses were designed as
though the knee were biomechanically as straightforward as the hip.
Alas, numerous complexities soon became apparent; in response the
models multiplied-and multiplied-until the ordinary orthopaedic
practitioner became hopelessly bewildered. He found himself
subjected to high pressure propaganda; from the surgeon offering a
miracle cure, from the engineer seeking fame and from the
manufacturer expecting fortune. Visiting his unit as a team, this
trio was well-nigh irresistible.
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