Arthritis of the knee is a common complaint. Loss of the articular cartilage between the bone ends forming the joint, results in the joint becoming stiff, swollen and painful. This process can take years to occur or can become apparent over a short period of time, often preceeded by a minor injury or episode of over-use. Pain is often “start-up” in nature and improves with use although the pain is usually made worse with activity. Sleep disturbance often drives people to seek a surgical solution when non-operative stategies of exercise, weight reduction and medication fail to provide relief. Unfortunately, there is no “cure” for arthritis of the knee. Knee arthroscopy has a limited role in treating an arthritic knee. Changing the alignment of an arthritic knee (osteotomy) is a temporising solution but may not abolish the symptoms of an arthritic knee. The most reliable solution to an arthritic knee is a total knee replacement procedure.
Patients complain of knee pain often following an injury. If pain and swelling persist following an injury, and are not responding to physiotherapy, prompt assessment is required. By taking a detailed history and performing a careful examination of the knee, a diagnosis can be made. Special investigations including x-rays and scans can often provide additional information and if necessary, help plan surgery.
Total Knee Replacement
The arthritic joint surfaces are removed surgically and replaced by a man-made implant consisting of metal and plastic. Pain relief is excellent as is functional recovery. Throughout the world, 85% of patients who have had a knee replacement are happy with their new knee. The procedure requires a two to three day period in the hospital. Recovery is patient focussed with careful occupational and physical therapy input to enable a satisfactory outcome. Restriction of activity and driving is usual for approximately six weeks but by three months most patients are seeing good improvement in both their pain and function. Follow-up by your surgeon usually extends up to a year post op.
Injury to the joint surface, the stabilising structures (ligaments) or meniscal cartilage may benefit from surgery, often a “key hole” procedure (arthroscopy). Knee arthroscopy is performed as a day case procedure. Recovery following knee arthroscopy depends on the patient and procedure performed but most recover in two to four weeks.