The modern total hip   replacement was pioneered by Sir John Charnley in England in the   1960s. He found that joint surfaces could be replaced by metal or high   density polyethylene implants cemented to the bone with methyl   methacrylate bone cement. Since Charnley, there have been continuous   improvements in the design and technique of joint   replacement (arthroplasty) with many contributors, including W. H.   Harris, the son of R. I. Harris, whose team at Harvard pioneered   uncemented arthroplasty techniques with the bone bonding directly to the   implant. 
               
          Knee replacements using similar technology were started by McIntosh   in rheumatoid arthritis patients and later by Gunston and Marmor   for osteoarthritis in the 1970s developed by Dr John Insall in New York   utilizing a fixed bearing system, and by Dr Frederick Buechel and Dr   Michael Pappas utilizing a mobile bearing system. 
            
          Uni-compartmental knee   replacement, in which only one weight-bearing surface of an arthritic   knee is replaced, is an alternative to a total knee replacement in a   select patient population. 
            
          Joint replacements are available   for other joints on a limited basis, most notably shoulder, elbow,   wrist, ankle, spine, and fingers. 
            
          In recent years, surface   replacement of joints, in particular the hip joint, have become more   popular amongst younger and more active patients. This type of operation   delays the need for the more traditional and less bone-conserving total   hip replacement, but carries significant risks of early failure from   fracture and bone death.  |