The partial knee resurfacing procedure used by Dr. Redish was originally developed by Dr. John Repicci of Buffalo, New York; a dentist who became an orthopaedic surgeon and developed this procedure as a way of doing a minimally invasive unicondylar knee resurfacing. It is a unicondylar knee resurfacing, which means that only one of the two condyles or weight bearing halves of the knee is resurfaced while the other is left natural. Unicondylar knee replacements have been in existence almost since the time that total knees were developed, a good 40 years ago, but the old style unicondylar knee replacements used the same long incision as a total knee replacement, and were very difficult to revise to a total knee replacement because of the way they were constructed. Dr. Repicci solved both of those problems by developing an inlay system using a freehand technique of milling out a depression in the bone and cementing in a plastic surface, much in the same way as an inlay in a tooth would be done. He also made use of a rounded upper metal component that required sculpting of the bone with a dental instrument free hand. It was originally designed to be an intermediate procedure to allow younger patients to be able to delay the need for total knee replacement. The procedure removes a bare minimum of bone, making it simple to revise to another unicondylar or a total knee replacement. Fortunately with improved surgical techniques and greatly improved biomaterials it is felt that most patients will not need another procedure. It can be done through a small incision that does not disrupt the quadriceps muscle, thus the recovery is much easier than total knee replacement. At this date the drawback of this procedure is that it depends on a freehand technique that has not been perfected by most orthopaedic surgeons.
