Campbell, Clin Orthop Relat Res 1940 - Interposition of Vitallium Plates in Arthroplasties of the Knee. Preliminary Report. By Willis C. Campbell, 1940

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Interposition of Vitallium Plates in Arthroplasties of the Knee. Preliminary Report. By Willis C. Campbell, 1940

Campbell·Clin Orthop Relat Res·1940·8 citations·Case series

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A 1940 preliminary report by Willis C. Campbell describing the first use of vitallium metal plates as interposition material in knee arthroplasty. Campbell adapted Smith-Petersen's hip mold arthroplasty concept to the anatomically more complex knee joint in patients with post-infectious ankylosis. Results were preliminary and conclusions explicitly withheld pending longer follow-up.

Key Findings

Campbell treated only 2 patients with vitallium knee interposition at the time of writing (4 total by publication), all with post-infectious ankylosis. The series was too small for conclusions, and Campbell explicitly said so — this paper is a technical proof-of-concept, not an outcomes study.
Motion results were explicitly "disappointing" in both initial cases. Campbell attributed this to inadequate joint space rather than material failure, establishing joint space adequacy as the key technical variable for interposition arthroplasty success.
Knee anatomy required internal fixation of the vitallium plate: two posterior condylar flanges plus one anterior vitallium screw. This directly contrasts with Smith-Petersen's hip cup, which was left completely unfixed and relied on free motion between cup, femoral head, and acetabulum.
The target joint space for knee interposition arthroplasty was identified as approximately 3/4 inch between femoral and tibial surfaces. Campbell planned to enlarge future resections to match this dimension, used successfully in fascia lata arthroplasty.
Fascia lata interposition remained the preferred knee arthroplasty technique throughout this report. Vitallium was framed as experimental, worth investigating only because Smith-Petersen's hip results were encouraging.
Campbell planned two technical modifications for future plates:
- Fixed plates designed for easier removal if needed
- A tibial-side plate to replace the femoral-side plate
- These anticipated the concept of tibial component design decades before total knee replacement.
The biological rationale for interposition arthroplasty was fibrocartilaginous lining formation in the new joint space, observed by Smith-Petersen after vitallium hip interposition and by Campbell after fascia lata knee interposition. Both authors interpreted this as a favorable physiologic response to the interposition surface.

Board PearlKnee anatomy requires fixed interposition implants; the free-floating Smith-Petersen hip cup principle cannot be directly applied to the knee.

Interposition of Vitallium Plates in Arthroplasties of the Knee. Preliminary Report. By Willis C. Campbell, 1940.

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Interposition of Vitallium Plates in Arthroplasties of the Knee. Preliminary Report. By Willis C. Campbell, 1940

Campbell·Clin Orthop Relat Res·1940·8 citations·Case series

|

A 1940 preliminary report by Willis C. Campbell describing the first use of vitallium metal plates as interposition material in knee arthroplasty. Campbell adapted Smith-Petersen's hip mold arthroplasty concept to the anatomically more complex knee joint in patients with post-infectious ankylosis. Results were preliminary and conclusions explicitly withheld pending longer follow-up.

Key Findings

Campbell treated only 2 patients with vitallium knee interposition at the time of writing (4 total by publication), all with post-infectious ankylosis. The series was too small for conclusions, and Campbell explicitly said so — this paper is a technical proof-of-concept, not an outcomes study.
Motion results were explicitly "disappointing" in both initial cases. Campbell attributed this to inadequate joint space rather than material failure, establishing joint space adequacy as the key technical variable for interposition arthroplasty success.
Knee anatomy required internal fixation of the vitallium plate: two posterior condylar flanges plus one anterior vitallium screw. This directly contrasts with Smith-Petersen's hip cup, which was left completely unfixed and relied on free motion between cup, femoral head, and acetabulum.
The target joint space for knee interposition arthroplasty was identified as approximately 3/4 inch between femoral and tibial surfaces. Campbell planned to enlarge future resections to match this dimension, used successfully in fascia lata arthroplasty.
Fascia lata interposition remained the preferred knee arthroplasty technique throughout this report. Vitallium was framed as experimental, worth investigating only because Smith-Petersen's hip results were encouraging.
Campbell planned two technical modifications for future plates:
- Fixed plates designed for easier removal if needed
- A tibial-side plate to replace the femoral-side plate
- These anticipated the concept of tibial component design decades before total knee replacement.
The biological rationale for interposition arthroplasty was fibrocartilaginous lining formation in the new joint space, observed by Smith-Petersen after vitallium hip interposition and by Campbell after fascia lata knee interposition. Both authors interpreted this as a favorable physiologic response to the interposition surface.

Board PearlKnee anatomy requires fixed interposition implants; the free-floating Smith-Petersen hip cup principle cannot be directly applied to the knee.

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