Types
of
Knee Replacement Surgery
In total knee replacement surgery, the parts
of the bones that rub together are resurfaced
with metal and plastic implants. Using special,
precision instruments, your surgeon will typically
remove the damaged surfaces of all three bones.
The replacement surfaces will then be fixed
into place.
The surface of the femur is replaced with
a rounded metal component that comes very
close to matching the curve of your natural
bone. The surface of the tibia is replaced
with a smooth plastic component. This flat
metal component holds a smooth plastic piece
made of ultra-high-molecular-weight polyethylene
plastic that serves as the cartilage. The
undersurface of the kneecap may also be replaced
with an implant made of the same polyethylene
plastic.
We
offer the following types of Surgery:
 
Total
Knee Replacement (Zimmer High Flex Knee)
Oxford
Knee Replacement (Half Knee Replacement)
Bilateral
Knee Replacement (Double Knee)
Knee
Revision (Knee Arthroplasty)
Knee
Arthroscopy
Anterior
(ACL) & Posterior (PCL) Cruciate Ligament
Repair
Bakers
Knee Cyst (Popliteal Cyst)
Total
Knee Replacement (Zimmer
High Flex Knee)
Flex Fixed Knee or Zimmer High Flex Knee Replacement?
Both
Fix Flexed knee and hich flexed knees are
available. In some cases, the Flex Fixed Knee
may be an option for total knee replacement.
The basic surgical procedure for the Flex
Fixed Knee is the same as for any other total
knee replacement. Which knee to fit often
depends on patients lifestyle, and physical
carecteristics. This decision will dormally
be made in principal beforehand but can be
confirmed during the presurgery consultation
with the orthopaedic suregon.
The fix flexed knee is the more traditional
knee replacement fitted before the appearance
of the new high flex knee.
The
High-Flex Knee replaces the thighbone portion
of the knee. Knee replacements have long been
available in many different sizes, but pioneering
research conducted for Zimmer shows getting
a good fit is not just about size, it’s
about shape.
Zimmer branded knees have been implanted in
more than 5 million patients worldwide, and,
in 2002, the company became the first to reach
1 million total knee replacements in the USA.
Zimmer Implant Solutions are based on more
than 20 years of Zimmer’s success in
total knee replkacement implants and are designed
to be placed using existing surgical techniques,
including Zimmer Minimally Invasive Solutions™
(MIS) Procedures.
The High-Flex
Knee Replacement addresses two important issues:
Surgical method – minimally
invasive surgery typically offers smaller
scars, shorter hospitalisation and quicker
rehabilitation and recovery.
The flexing of the knee –
traditional knee replacement has lead to a
certain amount of loss of mobility of the
knee joint the amount of total flexing possible
with a standard knee replacement causes reduced
flexing and mobility. The High-Flex Knee replacement
accommodates high flexion (up to 155 degrees).
Oxford
Knee (Half
Knee Replacement)
The
“Oxford knee or half knee replacement
is generaly known as the unicompartmental
knee prostheses replaces half of the joint
where catrtelage is worn out on one side only.
The total knee prostheses replace the entire
knee joint.
Bilateral
Knee Replacement
(Double Knee)
When
the cartilage has worn away in both knees,
an artificial knee (called a prosthesis) can
take its place. The surgery to implant both
of the prosthesis is termed a Bilateral Total
Knee Replacement. Only the surface of the
joint is removed - the arthritic ends of the
bones are shaved off and replaced with new
metal and plastic surfaces. The knee replacement
recreates almost normal function of the knee,
and its main goal is to relieve pain.
Knee
Revision
(Knee Arthroplasty)
Knee
revision surgery, which is also known as revision
total knee arthroplasty, is a procedure in
which the surgeon removes a previously implanted
artificial knee joint, or prosthesis, and
replaces it with a new prosthesis. Knee revision
surgery may also involve the use of bone grafts.
The bone graft may be an autograft, which
means that the bone is taken from another
site in the patient's own body; or an allograft,
which means that the bone tissue comes from
another donor.
Knee revision surgery has three major purposes:
relieving pain in the affected hip; restoring
the patient's mobility; and removing a loose
or damaged prosthesis before irreversible
harm is done to the joint.
Knee
Arthroscopy
Arthroscopy
is a "keyhole" operation that is
used to look inside and treat joints, especially
the knee joint.
It
is performed through very small incisions
in the skin, using a narrow telescope (arthroscope)
attached to a video camera. Compared to open
surgery, which involves a larger incision,
keyhole surgery is less painful, carries less
risk of infection, and enables people to recover
more quickly.
An arthroscopy may be used to investigate
knee problems, treat conditions such as arthritis
and inflammation, take small samples of tissue,
or repair damage to tissues and cartilage.
Anterior
(ACL) & Posterior (PCL) Cruciate Ligament
Repair
Anterior
Cruciate
Ligament (ACL)
Repair
Once the ligament is deemed repairable, sutures
are then passed through the proximal aspect
of the ligament. A posterior intercondylar
notchplasty is performed between the two femoral
condyles of the thigh bone. The area is then
microfractured with a series of small punctures
deep into the posterior notch to create a
bleeding bed. The anatomic insertion site
in this notch where the ACL tore from is identified
and a hole placed. A suture anchor is then
loaded into the sutures, passed into the hole,
and the sutures then tied with a fisherman's
slip knot, in order to pull or secure the
ACL back into the anatomic insertion site.
Autogenous blood clot (performed with the
patients own blood) is then harvested and
mixed into a fibrous clot, then packed into
the proximal site to improve the healing bed.
Sutures are then tied over the fibrous clot
to hold it into place.
Posterior
Cruciate
Ligament (PCL)
Repair
The Posterior Cruciate Ligament (PCL) is larger
and stronger than the Anterior Cruciate Ligament
(ACL). It passes backwards and downwards from
the bottom of the femur (thigh bone) to the
top of the tibia (shin bone). Its main purpose
is to prevent the tibia slipping backwards
on the femur.
PCL
injuries occur in athletes and multiple-trauma
victims. Regardless of the specific cause,
the mechanism of injury remains fairly consistent
- a blow to the front of the upper tibia.
In motor vehicle accidents this occurs as
the top of the tibia strikes the dashboard.
In sports, a PCL injury can occur when an
athlete falls to the ground on a bent knee,
causing the upper tibia to strike the ground
first. A prominent tibial tubercle resulting
from Osgood Schlatter's disease may enhance
the impact when the tibia strikes the ground.
One
study estimates that PCL injuries make up
as many as 20% of all knee ligament injuries,
but the diagnosis is often missed. This is
due to the fact that many people can function
normally without a PCL. However, detection
of PCL injury is important because untreated
PCL ruptures will lead to significant degeneration
(i.e. osteoarthritis) of the knee and disability
in later life.
Bakers
Knee Cyst (Popliteal
Cyst)
You notice a bulge behind your knee, and you
feel tightness there, too. The pain gets worse
when you fully extend your knee or when you're
active. What could be the cause?
A
likely explanation is that you have a Baker's
cyst, also called a popliteal cyst. A Baker's
cyst is usually the result of a problem with
your knee joint, such as arthritis or a cartilage
tear. Both conditions can cause your knee
to produce too much fluid, which can lead
to a Baker's cyst. Treating the probable underlying
problem usually relieves the swelling and
discomfort of a Baker's cyst.
These
cysts occur most often in adults between 55
and 70 and in children between 4 and 7 years
old. Up to one in five people with other knee
problems may develop a Baker's cyst.
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