In good news for the 100,000 patients who undergo the procedure in the UK each year, traction - a technique known to the military surgeons of Ancient Greece - could become an integral part of modern knee replacement surgery, according to a study published in the International Journal of Orthopaedics.
The study was carried out at the Peninsula NHS Treatment Centre, Plymouth, UK, by Consultant orthopaedic surgeon James Brown.
Traction has been used by a small group of knee surgeons over the past few years to set the depth of cut on the top of the leg bone (tibial plateau), but this technique has not previously been compared to standard techniques in the orthopaedic literature. Now, in a retrospective study involving 140 patients, Mr Brown has shown that traction leads to a bone-conserving depth of cut, removing only the minimal amount of bone and cartilage that is needed to implant the artificial knee.
Commenting on the study Mr Brown said: "When carrying out knee replacement surgery, surgeons prefer to avoid the excessive removal of bone to the benefit of the patient and this method does prevent this. Traction is an ancient technique that is very powerful in its effect, and is used every day in trauma theatre. This study confirms that the depth of tibial cut is reliable and reproducible when using traction. In the future, this strand of research could feed into the broader question of alignment and soft-tissue balancing in knee replacement, which is currently a controversial topic and the subject of much research".