Knee Surgical Treatments
Arthroscopic-Assisted Anterior Cruciate Ligament ACL Reconstruction
This is the most common reconstructive treatment Dr South performs.
It is used in younger people with a sporting injury, and its aim is to restore the joint to as near a natural state as is possible. It uses the person’s own tissues to “reconstruct” the knee to its former state. It is totally different to a “replacement” which is used for older people with a damaged knee. The anterior cruciate ligament is one of the major stabilizing ligaments in the knee. It is a strong rope like structure located in the centre of the knee running from the femur to the tibia. When this ligament tears unfortunately it doesn’t heal and often leads to the feeling of instability in the knee.
Total Knee Replacement
This is the most common major operation Dr South performs. Real-time computer navigation is utilised (read more in the next section). Knee replacement surgery is the last resort to relieve pain and restore function in a knee damaged by arthritis or an injury, when non-surgical treatments do not relieve the condition. It is an artificial device, and can never replicate the wondrous complexity and function of a well-performing natural human knee. It is totally different to a “reconstruction” which is performed in a younger person with a damaged ligament and which uses the natural tissue of that person to reconstruct the specific ligament.
Ideally a replacement should be reserved for people over sixty-five years of age with significant pain, deformity and disability. It can be performed in younger people, however the satisfaction rates are lower and the failure rates higher than in the older group.
The procedure involves replacing the damaged surfaces of the articulating bones with man-made implants. Deformity is corrected, and the painful joint surfaces no longer rub on each other. Satisfaction rates world-wide are of the order of eighty percent. Published data suggests ten percent of people never like their new knee. Depression, anxiety, obesity and high pre-operative use of strong pain-killers and anti-depressants are associated with lower satisfaction levels. In some people, the soft tissues around the knee remain sore for an extended period of time. The new joint surfaces cannot feel pain, and also cannot give joint-position feedback to the person. This is probably why they rarely feel “normal”. Realistic expectations, patience and hard work will usually result in a favourable outcome.
Computer Navigation for Total Knee Replacement
Dr South uses real-time computer-guided navigation for his knee replacements. This allows for accurate bone cuts and excellent alignment. Such alignment is particularly important for those under sixty-five years of age and has been shown in the Australian Joint Registry to confer better long-term survival of the implants.
Knee Arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to look inside the knee joint to diagnose or treat a knee problem. It is a relatively safe procedure and most patients discharge from the hospital on the same day of surgery.
Osteoarthritis is the most common form of arthritis which affects the articular cartilage (tissue covering the ends of the bones) of the knee and other joints such as shoulder, hip, ankle and foot. The articular cartilage cushions the joint so that there is smooth and pain-free movement between the bones in the joint. In this condition, the articular cartilage is completely worn off, as a result the ends of the bones rub against each other causing pain and inflammation. Debridement was once commonly used for arthritis, however recent research suggests it is of little long-term value.
Partial meniscectomy is a surgical procedure to remove the torn portion of the meniscus from the knee joint. The meniscus is the C-shaped cartilage located in the knee that lubricates the knee joint, acts as a shock-absorber, and controls the flexion and extension of joint. Meniscal tears can occur at any age, but are more common in athletes playing contact sports.
Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A suddenly bend or twist in your knee can cause the meniscus to tear. This is a traumatic meniscus tear. These injuries in younger people with supple tissues can often be successfully repaired.
Older people are more prone to degenerative meniscal tears as the cartilage slowly weakens and dies with age. Scientific studies have shown that it is very common for older people with no knee pain to have “meniscus tears” reported on MRI scans. It is debatable whether key-hole treatment of these gives any long-term benefit to the patient.
Medial Patellofemoral Ligament Reconstruction
Medial patellofemoral ligament reconstruction is a surgical procedure indicated in patients with more severe patellar instability. The medial patellofemoral ligament is a band of tissue that extends from the femoral medial epicondyle to the superior aspect of the patella.
The posterior cruciate ligament (PCL) is one of four major ligaments of the knee situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia). The PCL limits the backward motion of the shinbone.
Click on the topics below to find out more from the orthopaedic connection website of American Academy of Orthopaedic Surgeons.
- ACL Injury: Should it be fixed?
- Activities After a Knee Replacement
- Additional Resources on the Knee
- Adolescent Anterior Knee Pain
- Arthritis of the Knee
- Care of the Aging Knee: Baby Boomers May Need Lifestyle Changes
- Cemented and Cementless Knee Replacement
- Deep Vein Thrombosis
- Frequently Asked Questions about Osteoarthritis of the Knee
- Goosefoot (Pes Anserine) Bursitis of the Knee
- Knee Arthroscopy
- Knee Arthroscopy Exercise Guide
- Knee Implants
- Knee Replacement Exercise Guide
- Kneecap (Prepatellar) Bursitis
- Meniscal Tear
- Meniscal Transplants
- Minimally Invasive Total Knee Replacement
- Nonsurgical Treatment Options for Osteoarthritis of the Knee
- Orthopaedists Research Female Knee Problems
- Osgood-Schlatter Disease (Knee Pain)
- Osteonecrosis of the Knee
- Posterior Cruciate Ligament (PCL) Tear
- Rotating Platform/Mobile-bearing Knees
- Runner’s Knee (Patellofemoral Pain)
- Surgical Treatment of Osteoarthritis of the Knee
- The Knee
- Total Knee Replacement
- Unstable Kneecap
- Viscosupplementation Treatment for Arthritis