Total Knee Replacement
A total knee replacement (also known as total knee arthroplasty) is an operation performed to replace a worn-out knee joint. The joint becomes worn-out most commonly as a result of osteoarthritis, but can also result from other causes such as trauma or injuries, inflammation (e.g. rheumatoid arthritis), infection and overuse. The aim of a TKR is to relieve pain, restore function and movement, and improve quality of life.
The diseased joint and bone is removed and replaced with a new artificial knee joint. The artificial knee joint is made from a surgical-grade metal alloy with a special wear-resistant plastic insert. TKRs are one of the most successful operations available today with over 90% still functioning well at 15 years.
What are the symptoms of joint damage requiring a knee replacement?
Most patients complain of severe pain in the knee. This pain can be felt deep inside the knee or in the front, sides or back of the knee. There is often associated swelling around the knee. The pain is often made worse with walking.
Articular or hyaline cartilage is the tissue lining the surface of two bones in a joint. It helps the bones to move smoothly against each other and can withstand the pressure of activities such as running and jumping. Articular cartilage does not have a direct blood supply so it has less capability of repairing by itself and can lead to degeneration of the articular surface (osteoarthritis). Chondroplasty refers to the surgical repair of torn or damaged cartilage.
It is usually performed as a day-case surgery through arthroscopy. An arthroscopic procedure involves the insertion of a telescope through a small incision, allowing your surgeon to clearly view the operating site on a monitor without having to make a large opening.
Microfracture is a surgical procedure performed to promote the healing of damaged cartilage with the use of stem cells (progenitor cells of the body). It is considered the best procedure to treat cartilage injuries less than ½ inch or 15 mm. Microfracture is widely used to treat hip and knee injuries.
The microfracture technique is usually performed as an arthroscopic procedure (arthroscope is an instrument consisting of a small camera to view the area of injury) under local, spinal or general anaesthesia. Three small incisions are made to insert the arthroscope and other instruments.
Revision Knee Replacement
Revision knee replacement means that part or all of your previous knee replacement needs to be revised. This operation varies from very minor adjustments to massive operations, replacing significant amounts of bone. The typical knee replacement replaces the ends of the femur (thighbone) and tibia (shinbone) with plastic inserted between them, and usually the patella (knee cap).Read More
Computer-assisted Total Knee Replacement
A total 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 symptoms. The procedure involves replacing the damaged surfaces of the articulating bones with an artificial implant. Most of these implants wear with use. Thus, the need for revision surgery is high in young and active people if the implant has to last the lifetime of the patient.
Medial Patellofemoral Ligament Reconstruction
Medial patellofemoral ligament reconstruction is a surgical procedure indicated in patients with more severe patellar instability. Medial patellofemoral ligament is a band of tissue that extends from the femoral medial epicondyle to the superior aspect of the patella. Medial patellofemoral ligament is the major ligament which stabilizes the patella and helps in preventing patellar subluxation (partial dislocation) or dislocation.
This ligament can rupture or get damaged when there is patellar lateral dislocation. Dislocation can be caused by direct blow to the knee, twisting injury to the lower leg, strong muscle contraction, or because of a congenital abnormality such as shallow or malformed joint surfaces.
High Tibial Osteotomy
High tibial osteotomy is a surgical procedure performed to relieve pressure on the damaged site of an arthritic knee joint. It is usually performed in arthritic conditions affecting only one side of your knee. The aim is to take pressure off the damaged area and shift it to the other side of your knee with healthy cartilage. During the surgery, your surgeon will remove or add a wedge of bone either below or above the knee joint, depending on the site of arthritic damage.
High tibial osteotomy is commonly suggested for patients with osteoarthritis that is isolated to a single compartment (unicompartmental osteoarthritis).
Cartilage Repair and Transplantation
The articular cartilage is a white tissue lining the ends of bones where they connect to form joints. The cartilage acts as cushioning material and helps in the smooth gliding of the bones during movement. An injury to the joint may damage this cartilage, which cannot repair on its own. The cartilage can be damaged with increasing age, normal wear and tear or trauma. The damaged cartilage cannot cushion the joints during movement and the joints may rub over each other, causing severe pain and inflammation.
Cartilage restoration is a surgical procedure where an orthopaedic surgeon stimulates the growth of new cartilage to restore its normal function. Arthritis can be delayed or prevented through this procedure.