Knee arthritis

Arthritis may develop as a result of general wear and tear or may be as a result of a previous injury. Less frequently there may be an inflammatory type of arthritis that may run in families.

Arthritis can give rise to pain that interferes with day-to-day activities, causes stiffness, swelling, and disturbs sleep. There may be a change in shape or alignment of the leg as a result.

Early stages of arthritis can be treated with painkillers, modification of activities, injections.

Sometimes keyhole (arthroscopic) surgery is beneficial particularly if there are localised areas of cartilage change or if there are symptoms of locking. There are realignment operations that can be performed.

More advanced arthritis may be suitable for either partial or total knee replacements depending on the pattern of arthritis and the integrity of ligaments.

Total knee replacement involves removing the worn out cartilage and bone. It is replaced with a smooth metal surface that articulates with a plastic (polyethylene) insert. The kneecap (patella) may or may not need replacing in addition.

I am a firm believer in only replacing the part of the knee that is currently worn out, especially in younger patients. This surgery is designed to preserve bone and ligaments and as a result the movement may feel more natural than a total knee replacement. The most popular partial replacement is a medial unicompartmental replacement where the arthritis is confined to the inner part of the knee. However I commonly perform isolated kneecap (patellofemoral) replacements and a dual compartment replacement where the inner part and the kneecap have advanced arthritis.

Many patients are not offered the chance to discuss knee replacements because it is felt that they are too young. However there are a wide range of solutions for younger patients now.

Hip Arthritis

Hip arthritis commonly causes pain, limping, stiffness getting in and out of cars, baths, difficulty putting on shoes and socks. Sleep can be disturbed.

Milder forms can be treated by painkillers, walking aids, injections.

Total hip replacement has been a revolution since its popularity increased in the 1970s. Modern hip replacements have changed a great deal from the early days, and now offer improved range of movement, lower wear rates, more natural feeling, and biological fixation to bone.

Every individual is different with regard to the shape of the hip, the size of ball and socket and activity profile. I am very keen to restore the correct biomechanics of the hip to optimise range of movement, reduce dislocation risk and strive to achieve equal leg lengths.

There are many different hip replacement solutions and articulating surfaces and each has its own pros and cons which we can discuss at your appointment to choose the correct solution for your arthritic hip. Similar to knee replacements, there are many solutions for younger patients designed to allow an increased activity profile and lower wear rate.

Cartilage tears

Cartilage tears in the knee may follow a twisting injury or a blow to the knee during sport or a fall. Occasionally the event cannot be remembered.

The symptoms can include pain, locking, stiffness, weakness, swelling, giving way.

Cartilage tears are often amenable to keyhole (arthroscopic) surgery which is performed as a daycase and designed to get you back to normal function as quickly as possible.