Patient Services : Knee Surgery
We provide comprehensive orthopaedic services for all conditions of the knee including anterior cruciate ligament (ACL) reconstruction, cartilage repair, chondromalacia and knee arthroscopy.
The Clinic offers a wide range of expertise and treatment options. We specialise in both open and arthroscopic surgery. The most common types of surgery performed are anterior cruciate ligament (ACL) reconstruction, cartilage repair, arthroscopic knee surgery and surgical replacement of the knee joint.
Anterior Cruciate Ligament Reconstruction
Virtually every patient who tears their anterior cruciate ligament has difficulty with any activity that requires sudden stops, starts, jumping, twisting and missteps, such as going down stairs, walking on rough ground or stepping off a curb. These are activities which require sudden change in momentum and direction and are the ones usually most significantly hampered with a torn anterior cruciate ligament. Patients usually feel that the knee gives way, pops, slips out or something similar. When this occurs, the knee hurts, sometimes rather severely, and will usually become swollen. An athlete's knee, in particular, is seriously compromised when an anterior cruciate ligament has been torn.
MACI (Matrix- Induced Autologous Chondoctyle Implantation)
Damage to the hyaline articular cartilage in the knee may lead to the accelerated onset of osteoarthritis. Lesions of the articular cartilage affect millions of people worldwide, but treatment is hampered by the fact that in adult life hyaline articular cartilage is limited in its ability to regenerate. This handout briefly outlines the structure and function of hyaline articular cartilage and an innovative new treatment known as matrix-induced autologous chondrocyte implantation (MACI).
MACI Patellofemoral Joint
Chondromalacia / Patellofemoral Pain
Pain around the front of the knee is often referred to as patellofemoral pain. This pain may be caused by soft cartilage under the kneecap (patella), pain from another area such as the back or hip, or soft tissues around the front of the knee.
In athletes, soft tissue pain in the front of the knee is fairly common. This may come from straining one or more of the following tendons:
- Patellar tendon - connects the kneecap to the lower leg bone
- Quadriceps tendon - connects the kneecap to the upper leg bone
- Retinaculum tendon - supports the kneecap on both the left and right
Chondromalacia is a condition that affects your kneecap, or patella. A patella that is affected with chondromalacia has varying degrees of pitting, irregularity, fissuring, softening, roughness, increased wear and, in advanced cases, can sometimes be worn down to the bone. Another way of thinking about this disorder is having arthritis on the back of the kneecap and, in fact, if looked at under the microscope, it is approximately the same thing. A knee with this problem hurts, swells and grinds. However, a lot of patients have chondromalacia of the patella and have no symptoms other than a grinding sensation when they squat or climb stairs.
Meniscal Cartilage Tears
The most common form of injury is a twist or deep squat. This is often a painful episode accompanied by one or more of the following symptoms - pain, clicking, popping, catching, locking, buckling, giving way and/or swelling. Locking occurs when the torn part of the cartilage gets caught between the bones and cannot get out. Some patients however, can tear a cartilage and have no specific recollection of when or how they did it. In general, the cartilage is tougher and harder to tear in young people and a history of significant trauma is more often the case in this age group.
Meniscal Cartilage Tears
Osteoarthitis of the Knee / Total Knee Replacement
Osteoarthritis, sometimes called degenerative arthritis, is caused by breakdown of the articular cartilage on the ends of the bones inside the joints. When the cartilage wears totally off the end of the bones, there is bone-on-bone contact. This is usually rather painful.
Articular cartilage is the slick white substance that covers the end of the bones and joints and is abnormal or worn in patients with arthritis. If you take a chicken joint and pull it apart, there is a glistening white substance on the ends of the bone. This is an example of articular cartilage.
When the pain and dysfunction of athritris in the knee is severe enough to impact on your work and daily activities, it is usually the time to consider a total knee replacement. I have compiled this handout to be sure that you are informed of the nature of the operation and what to expect, both good and bad. After reading this information you should be able to decide whether or not you would like to proceed with the surgery or whether to delay your decision for a period of time, possibly indefinitely.