Knee Surgery

James sees and treats a number of conditions related to the knee, and has particular interest in sporting injuries of the knee.

Some of the more commonly seen problems with the knee include:

• Knee Arthritis

• ACL tears

• Meniscal Tears

Knee Arthritis

Osteoarthritis is the most common form of arthritis. This is when the smooth cartilage which lines the ends of the bones wears out. This creates a stiff and painful joint. The symptoms of this can range from a minor annoyance to severely debilitating.

Initial management of the osteoarthritic knee joint involves activity modification, weight loss, physiotherapy, and simple pain medication and anti-inflammatories.

When non-operative management fails, surgery can be considered.

Knee replacement surgery is the main surgical treatment of the osteoarthritic knee.

This involves cutting away the worn out surfaces of the hip joint, and replacing them with prosthetic components. The goal of this surgery is to alleviate pain and improve function.

ACL Tears

ACL tears are a commonly seen sporting injury of the knee.

The ACL is and important stabiliser of the knee, especially with any sports that require cutting or pivoting movements.

The ACL does not have a very good ability to heal itself, and often surgery is required to reconstruct the ACL.

An ACL reconstruction involves taking a tendon graft from the patient, and utilising this to create a new ligament. This is secured into tunnels created in the tibia and femur.

Common grafts include hamstring, patella tendon and quadriceps tendon. The choice of graft will be tailored to the individual patient.

Meniscal Tears

The meniscus is a shock-absorbing cartilage in the knee. Each knee has a pair of menisci - medial and lateral.

Meniscal tears can either be acute or degenerative.

Acute tears are generally seen in younger individuals - often in association with other ligamentous injuries of the knee. These can often require surgical repair or debridement, particularly if they cause locking or catching of the knee.

Degenerative tears are usually associated with osteoarthritis of the knee. These can often be incidental finding on imaging, and not the true cause of knee pain, which is usually the underlying arthritis.

Modern evidence indicates that the best management of these degenerative tears is non-operative