Although unicompartmental – or ‘half knee’ replacements - are available, arthritic knees usually require a total knee replacement. This surgery resurfaces the femur, tibia and patella and introduces a layer of polyethylene between the femur and tibia as a plastic shock absorber to eliminate the pain of osteoarthritis.
Studies have shown that a well aligned and functioning knee replacement should last between 25-30 years. Using computer navigated, patient specific instruments Professor Ali Ghoz can treat the knee and help patients become pain free.
Professor Ali Ghoz tends to cement the replacement onto the bone rather than allow for the bone to grow onto the prosthesis, as patients tend to recover a little quicker and experience less pain and discomfort.
It has been found that over 85% of knee replacements will achieve a good, pain-free functional result allowing patients to live a full and active life.
A total knee replacement (TKR) or total knee arthroplasty is a surgery that resurfaces an arthritic knee joint with an artificial metal or plastic replacement called the prosthesis.
Surgery in which only part of the knee joint is replaced through a smaller incision than would normally be used for a TKR. The knee joint is made up of three compartments – the patellofemoral and medial and lateral compartments between the femur and tibia. Often only one of these compartments wears out.
This is when part or all of a previous knee replacement needs to be revised. These operations can vary from very minor adjustments to massive procedures replacing significant amounts of bone.
Preventing thrombosis is the priority after hip and knee replacement surgery. Mobilisation and exercise are vital. To aid this every patient is fitted with a calf compressor that promotes blood flow and prevents clots. Every patient will be prescribed oral blood thinning medication following surgery to guard against the risk of Deep Vein Thrombosis.
The sooner a patient gets out of bed and walks the less the risk of thrombosis so Professor Ali Ghoz encourages his patients to walk twice a day whilst in the hospital. The more exercise the better but patients are warned not to overdo things.
Although there may be some discomfort the keys to a successful recovery after replacement surgery – even the minimally invasive techniques offered by Professor Ali Ghoz – are mobilisation and hydration.
Physiotherapists will be able to show patients exercises to help recovery and ensure that surgery is just the start of a new way of life.
Knee cap (patellofemoral) instability occurs when the knee cap does not slide centrally within the groove of the thigh bone. The knee cap can be tilted, partially come out of the groove (subluxation) or completely come out (dislocation).
Understanding the causes for such instability has become greater over the years and with individual diagnosis Professor Ghoz can decide what is the best course of action for each patient.
The three most common causes for dislocation are traumatic dislocation, trochlear dysplasia (flattening) and maltracking secondary to bone malalignment. When the underlying cause is understood then the appropriate treatment can be implemented.
Surgery is usually a last resort in the management of patellofemoral pain. It may be effective in preventing recurrences of dislocation, prevent patellofemoral impingement and reduce pain. The aim is always to enable all patients to get back to their normal active daily routines if possible.
Patients will tend to stay in hospital overnight after ACL reconstruction surgery. Even though the procedure is minimally invasive it does have an impact on the initial strength of the knee but most patients will not need a brace.
Professor Ali Ghoz advises physiotherapy as soon as possible as this will determine the speed of recovery. Patients can expect to be on crutches for around two weeks, jogging in a straight line after three months and running with pivoting in just seven months. A return to competitive sport can come as soon as 9-12 months after surgery.
With advice from physiotherapists, Professor Ghoz can provide a full ACL Reconstruction rehabilitation programme.