Knee procedures

We understand that every patient is unique, and every injury is slightly different. During your consultation Dr Gifford will review your scans and physically assess your injury before discussing what options are available to you.

Many injuries can be managed conservatively before considering a surgical procedure, but once a person is ready to consider knee surgery, Dr Gifford may recommend one or two surgical options. Many sports injuries are repaired through an Arthroscopic or ‘key hole’ procedure, while more extensive injuries and joint replacements for Arthritis may have a number of options to consider. 

The most common surgeries to treat knee arthritis are

• Cartilage repair and restoration

• Knee arthroscopy

• Knee osteotomy (tibial osteotomy or femoral osteotomy)

• Partial knee replacement (unicompartmental knee arthroplasty)

• Total knee replacement (total knee arthroplasty)

Arthroscopy

Knee arthroscopy, also known as ‘key hole’ surgery allows for minimally invasive exploration and repair of the knee joint while preserving the soft tissues through the use of highly specialised precision instruments and a small camera. 

Arthroscopy is used preferentially due to its many benefits including decreased pain and swelling as well as earlier mobilisation. There are some injuries that may not be appropriate for arthroscopy and require an open procedure, and your options will be discussed with reference to your specific injury during consultation with Dr Gifford.

Unicompartmental Knee Replacement

While a knee replacement can bring a great deal of relief and bring pain free movement back into your life, we know that nothing can ever compare to your original knee in its pre-diseased state. For this reason, a unicompartmental knee replacement may be an option if only one of the three compartments in your knee is affected by arthritic changes, and the defect is within an appropriate range.

The three compartments of the knee

1. Medial compartment (most common)

2. Lateral compartment

3. Patellafemoral compartment

The most common site of osteoarthritis is the medial compartment. As cartilage wears away, there is increased load past onto the exposed bone causing pain and instability. 

In this procedure the condyle and tibial plateau are replaced on the affected side leaving the healthy compartments of your knee remaining. Particularly for a young, active person, a unicompartmental knee replacement has the additional benefit of leaving both the ACL and PCL intact and allowing the knee to function in much the same way pre- and post-op.

Advantages of a partial knee replacement

• Preserve more of your own natural knee

• Improved range of motion

• Faster recovery

• Slight less risk of infection

Risks

• Partial knee replacement will not prevent progression of arthritis in the remaining two joint compartments.

• Large deformities around the knee are not able to be corrected

Total Knee Replacement

If there are arthritic changes in two or more compartments you may be a candidate for a total knee replacement.

A Total Knee Replacement replaces both tibial and femoral articulating surfaces with surgical grade metal alloy prostheses, separated by a modular polyethylene insert. A total knee replacement is a reliable procedure to improve pain and alignment.  Surgery removes the arthritis joint tissue and restores alignment of the limb. 

The Australian Joint Registry shows that 94% of TKR’s are still intact at 10 years post operation.

ACL reconstruction

There are several ligaments that can be torn around the knee.  The most common is the MCL – which is most often treated with a brace and physiotherapy.  The ACL is the 2nd most common ligament injury, often playing sport changing direction with in contact with another player. 

Anterior Cruciate Ligament (ACL) reconstruction is a surgery to restore knee function after injury. The ACL is critical in maintaining stability of the knee through common activities.  Early enrolment in physiotherapy after injury is important to reduce swelling and restore range of movement. Dr Gifford can provide prompt appointments for planning a recovery pathway.  Not all ACL injuries require surgery but an examination and review of each patients situation is important to establish the best pathway to recovery.

The ACL can be reconstructed with various tissues:

• Hamstring

• Quadriceps

• Patella tendon

• Allograft

The success of ACL reconstruction can be improved with various interventions:

• Augmentation with extra-articular tendon reconstruction

• Care to repair associated meniscal tears

• Adequate time to rehab before returning to play

FAQs