KNEE

Knee arthroscopy

Arthroscopic knee surgery is keyhole surgery that is performed with two small incisions in the skin on either side of the kneecap (patella). Additional incisions are sometimes used. Repair and resection of torn cartilage, removal of loose bodies and reconstruction of knee ligaments are performed arthroscopically. Patients are generally able to weight bear after a knee arthroscopy depending on the procedure they have and can go home the same day.

Patella instability

Patella instability is common in adolescents and young adults, especially those who are very flexible. It can vary from isolated dislocation to recurrent dislocation and can cause significant pain and disability. Initial treatment includes bracing, muscle strengthening and physiotherapy in most cases. Some cases require reconstruction of the ligament that hold the patella in place. Other cases may require surgery to address the specific cause.

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ACL Reconstruction

The anterior cruciate ligament (ACL) is a major stabilizing ligament of the knee. This ligament is important for knee stability for sport and pivoting activities. ACL reconstruction is very common in Australia and is typically performed arthroscopically (keyhole surgery). It can be performed using either hamstring tendon, patella tendon or donor tendon.

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High Tibial Osteotomy

Osteoarthritis of the knee is treated in different ways in younger people. To preserve a younger persons’ knee, it may be appropriate to cut and realign the bone to redistribute the forces, offloading the part of the knee that is arthritic. This is called a high tibial osteotomy (HTO). The aim of this surgery is to delay knee replacement for as long as possible.

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Partial knee replacement

Partial knee replacement involves only replacing the part of the knee that is damaged. The advantage of this procedure is that it has a quicker recovery and the partially replaced knee feels more like a normal knee. A disadvantage is a higher rate of revision operation compared to total knee replacement.

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Total knee replacement

A total knee replacement (TRK) is an operation that restores the cartilage of a painful damaged knee with a prosthesis. The Australian Orthopaedic Association National Joint Replacement Registry shows 95% of knee replacements are still functioning 15 years after surgery. Knee replacements usually do not feel as good as a normal knee but function much better than a painful arthritic knee. Robotic surgery may help with positioning of the knee prosthesis and improve outcomes.

Revision knee replacement
Revision knee replacement is required for a variety of conditions, such as prosthesis loosening, instability and infection. It can be minor or very complex requiring a large prosthesis, staged surgery or bone grafting.

Bursitis

Patellar bursitis is inflammation of the bursa over the front of the knee. A bursa is a lubricating sac that allows ligaments or tendons to slide over each other or bones at different locations around the body. Patella bursitis can usually be treated with modification of activities and medications but sometimes requires surgery to remove it if non-surgical treatment does not work.