Anterior Cruciate Ligament (ACL) Tears
The anterior cruciate ligament, or ACL, is one of the major ligaments of the knee that is located in the middle of the knee and runs from the femur (thigh bone) to the tibia (shin bone). It prevents the tibia from sliding out in front of the femur. Together with posterior cruciate ligament (PCL) it provides rotational stability to the knee. An ACL injury is a sports related injury that occur when the knee is forcefully twisted or hyperextended.
An ACL tear usually occurs with an abrupt directional change with the foot fixed on the ground or when the deceleration force crosses the knee. Changing direction rapidly, stopping suddenly, slowing down while running, landing from a jump incorrectly, and direct contact or collision, such as a football tackle can also cause injury to the ACL.
What is a meniscal tear?
The meniscus is a specialised cartilage that helps cushion the knee (“shock absorbers”) and protects the cartilage lining the joint (ie. the articular cartilage). It can tear as a result of an injury or fall which can cause significant knee pain and other mechanical symptoms. Meniscal tears are commonly associated with other injuries such as ACL rupture. Unfortunately, meniscal tears do not heal. As the meniscus is an important structure, damage can lead to osteoarthritis of the knee in the long term.
Knee pain is the predominant symptom usually followed by swelling within 24 hours. It may be difficult to walk for several days. These acute symptoms eventually resolve spontaneously.
Patella is the small piece of bone in front of the knee that slides up and down the femoral groove (groove in the femur bone) during bending and stretching movements. The ligaments on the inner and outer sides of patella hold it in the femoral groove and avoid dislocation of patella from the groove. Patellar (knee cap) instability results from one or more dislocations or partial dislocations (subluxations).Patellar dislocation is a condition that occurs when the kneecap or the patella completely shifts out of the groove towards the outside of the knee joint.
Normally, the kneecap fits in the groove, but uneven groove can cause the kneecap to slide off resulting in partial or complete dislocation of the kneecap.
Osteoarthritis, also called degenerative joint disease is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage).In a person with osteoarthritis, the cartilage becomes damaged and worn out causing pain, swelling, stiffness and restricted movement in the affected joint. This condition most commonly affects the joints in knees. Rarely, the disease may affect the shoulders, wrists and feet.
Causes and risk factors
Osteoarthritis is caused by the wearing out of the cartilage covering the bone ends in a joint. This may be due to being overweight, excessive strain over prolonged periods of time, previous fracture, growth abnormalities, joint diseases, injury or deformity.
Some people have congenital abnormalities of the joints that cause early degeneration and subsequently cause osteoarthritis.
What is an anterior cruciate ligament (ACL) reconstruction?
The anterior cruciate ligament (ACL) is an important major stabilising ligament within the knee. ACL sprains or tears are one of the most common knee injuries seen, particularly in those sports that involve twisting movements of the knee (such as football and netball). Unfortunately, ACL tears do not heal, often leading instead to instability of the knee. An ACL reconstruction is a surgical procedure to stabilise the knee by replacing (reconstructing) the torn ACL with another ligament graft. The graft is taken from tissues around the knee, such as the hamstring tendons or patella (knee cap) tendon. An artificial tendon graft may also be used. ACL reconstructions are usually performed arthroscopically (ie. key hole surgery).
Arthroscopic Meniscus Repair
Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A sudden bend or twist in your knees causes meniscal tear. This is a traumatic meniscus tear. Elderly people are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age. The two wedge-shape cartilage pieces present between the thighbone and the shinbone are called meniscus. They stabilize the knee joint and act as “shock absorbers”.
Torn meniscus causes pain, swelling, stiffness, catching or locking sensation in your knee making you unable to move your knee through its complete range of motion.
Patient Matched Knee Replacement
When planning a total knee replacement for patient surgeons conventionally use 2 dimensional X-ray images and a transparent template to decide the size and placement of the artificial knee components. Other surgeons plan the size and placement of the components during the actual surgery with the use of measuring instruments.
A new technique is now available called Patient Matched Knee Replacement. This new approach to preoperative planning utilizes 3 dimensional MRI images (magnetic resonance imaging) to provide the surgeon with a customized, 3D template for every patient prior to surgery.
What is Knee Arthroscopy?
Knee arthroscopy is a minimally invasive surgical procedure performed through 2 small 5-10mm incisions (ie. key hole surgery) using an advanced HD camera and special instruments to visualise and work inside the knee joint. Almost all aspects of knee conditions can be treated successfully with knee arthroscopy.
Knee arthroscopy is a minimally invasive approach resulting in less tissue damage, less pain, less blood loss, and faster recovery and return of function.
Unicompartmental (Partial) Knee Replacement
What is a uni-compartmental knee replacement (UKR)?
Patients with osteoarthritis that is limited to just one part of the knee may be candidates for a uni-compartmental knee replacement (also called a “partial” knee replacement). Your knee is divided into three major compartments: the medial compartment (ie. the inside part of the knee), the lateral compartment (ie. the outside part), and the patellofemoral compartment (ie. the front of the knee between the kneecap and thighbone). In a uni-compartmental knee replacement, only the damaged compartment is replaced with metal and plastic. The healthy cartilage and bone in the remainder of the knee is left alone. The knee joint becomes worn-out most commonly as a result of osteoarthritis but may also result from other causes such as trauma or injuries, meniscal tears and overuse. The aim of a UKR is to relieve pain, restore function and movement, and improve quality of life. The potential benefits of a UKR over a total knee replacement (TKR) are: the smaller incision, less bone removal, less blood loss, faster recovery, better range of movement and a more “natural” feeling knee. The disadvantages of a UKR compared with a TKR include slightly less predictable pain relief, and the potential need for more surgery.