Patchwork Knee Op That Cuts Recovery Time in Half

The Mail on Sunday (London, England), April 29, 2012 | Go to article overview

Patchwork Knee Op That Cuts Recovery Time in Half


Byline: Bonnie Estridge

Anew knee-repair operation that cuts recovery time in half is offering NHS patients with arthritis an alternative to a total joint replacement.

The procedure involves replacing only areas of cartilage that are diseased and leaves the ligament structures alone, allowing more natural movement.

Latest figures show that about 90,000 knee-replacement operations are carried out each year in Britain - which is higher than the number of hip replacements - with the biggest increase in those aged under 65.

Surgeons suggest that a traditional total knee replacement in a patient over 65 can last between ten and 15 years. In younger, more physically active patients, standard implants wear out faster.

Now the NHS is offering a sophisticated new replacement called bicompartmental knee resurfacing.

Philip Chapman-Sheath, Consultant Orthopaedic Surgeon at Spire Southampton Hospital, says: 'This operation is tailored to the specific needs of the patient as we are replacing only the parts affected by osteoarthritis.'

The knee joint is the largest in the body and consists of two hinges - one joins the tibia (shin bone) with the femur (thigh bone), while the other links the patella (knee cap) to the femur.

To keep each joint stable and flexible, the knee is supported by a framework of ligaments. In an arthritic joint, the cartilage that coats the end of each bone has worn away, exposing unprotected bone which then deteriorates. It is not known why this happens, but genetics and being overweight are factors.

Traditional total knee replacement involves a large incision with the surgeon replacing all areas of the joint - whether or not they are worn out - and removing ligaments.

In the new operation, the medial ligament of the knee - which runs along the inner knee - and the patella are replaced at the same time, sparing the other ligaments in the joint. Arthritic areas of cartilage are cut away and implants, made of chrome, titanium or hard-wearing plastic, are cemented or screwed into their place. The operation is carried out under spinal or general anaesthetic and takes about an hour. Patients usually go home within three days.

Experts have likened it to patching the knee of a pair of jeans. Mr Chapman-Sheath says: 'The implants replace the worn-out sections of cartilage, creating a new smooth surface.

'Because we leave the ligaments alone, afterwards patients are able to do much more in terms of nonimpact sporting activity such as golf, swimming and cycling, which might not have been possible after a total knee-replacement operation.'

However, this bicompartmental option can be used only once, so when the lateral or outer third becomes worn out, a total knee replacement would be needed. …

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