Knee arthritis is a common, debilitating condition that can significantly affect mobility and quality of life. Understanding its causes, treatments, and when surgery is required helps patients navigate the best path forward.
What is Knee Arthritis?
Knee arthritis is a common disorder that can be caused by repetitive injury, trauma, rheumatoid arthritis, or in many cases with no known cause. It is often quite debilitating as it affects the range of movement in the knee — making it hard to both bend and straighten the knee fully.
When the knee cannot be fully straightened, a fixed flexion deformity develops, which puts strain on other parts of the body by effectively shortening the leg. This can lead to hip and back pain. When the knee cannot bend past 90 degrees, it becomes very difficult to walk up and down stairs.
Non-Operative Management
Before surgery is considered, there are multiple things that can be done to diminish pain from arthritis. Knee replacements are successful operations but are not quite as reliable as total hip replacements, and the recovery can take slightly longer.
Non-operative options include anti-inflammatory medications, physiotherapy, walking aids, and weight management. These do not stop the progression of arthritis but can significantly reduce symptoms in the short to medium term.
Dr Liew's Approach to Knee Replacement
Dr Chien-Wen Liew performs total knee replacements using a specialised patient-specific technique. He believes this surgery is more tailored to each patient and results in a higher proportion of perfectly aligned knee replacements.
Patients who undergo this type of knee replacement will be required to undergo a series of tests prior to surgery. From the date of tests to the date of surgery, there is a lag time of approximately 4 weeks as the cutting blocks are manufactured. These blocks are unique to each patient and have a time limit after which they cannot be used.
The Surgical Approach — Preserving Muscle
The approach is very important in total knee arthroplasty. Dr Liew elects to use a minimally invasive surgical approach for all suitable patients, in keeping with his philosophy to preserve muscle attachment and minimise soft tissue damage.
This approach results in less muscle damage and a quicker recovery. Quadriceps recovery of function is more rapid and patella tracking is improved. There is also less bleeding with this method.
Conventional vs Patient-Specific Technique
Conventional total knee replacements are performed using jigs and cutting guides without any pre-navigation. The accuracy of these cuts is judged on how the instruments are placed. All surgeons who perform total knee replacements need to be experts in conventional techniques, as there may be a need to use this method when technology such as patient specific instruments fails — though this is rare at less than 0.1% in practice.
Total knee replacements are large operations that should be tailored to each individual patient. Dr Liew is a strong believer in optimising the surgical plan to ensure the highest proportion of patients are satisfied with their joint replacement.
Patient Information Summary
Download a PDF summary of this article to read later or share with family.