Surgical Procedures By Prof Kader
Primary Total Knee Replacement/Complex
Revision Total Knee Replacement
High tibial osteotomy/distal femur osteotomy
Patella re-alignment/ MPFL reconstruction
Knee Arthroscopy meniscal excision/repair,
Chondroplasty and Microfracture.
PCL reconstruction/combined ACL&PCL/multiligament
Knee Joint Osteoarthritis
Arthritis is degeneration of the knee joint. It happens with age or after trauma. Patient usually experiences deep dull ache in the bones of the knee. The pain at some stage becomes disabling and starts interfering with walking and activities of daily living
Normal knee has a glass like cartilage to help the join glide and it is well lubricated like an oiled engine
In arthritis the cartilage get damaged and become thinner with time. The joint becomes larger (swelling) and loses lubrication. As time goes by the joint becomes stiffer and harder to put weight through.
Best treatment at any stage of the disease is weight loss
Normally 3-5 times your body weight goes through the knee when you walk. Therefore if your weight is 80 Kg then up to 400Kg goes through the poor knee!! But when you lose 1 kg
there will be 5kg less going through the knee.
The Other Treatment
The other treatment is to strengthen the knee muscles by keeping active, walking all the time, Cycling, swimming, balance training and using the cross trainer
Cycling is the best swim as much as you can go on the cross trainer don’t run
When the pain increases and not responding to weight loss and execise then one can use pain killer. Start with paracetamol 500-1000mg four times a day with or without profen 400mg three times a day if your stomach is ok
If the pain is still bad then consider intraarticular injection of hyaluronic acid mild to moderate arthritis which may work up 3-6 months and steriod for severe arthritis (1-3months)
Occasionally the knee can improve for a period of time with artroscopy by debrifing the loose fragments, washout and trimming the meniscus
After All This
If you are still in pain then the only treatment is Joint replacement.
Total knee replacement has 90-95% success rate and it enables people to walk the next day with crutches and leave the hospital after 2-3 days. The operation improves 95% of the pain but the only thing is that the patient can not sit on a squat toilet