KNEE REPLACEMENT

Knee replacement surgery (arthroplasty) involves replacing a damaged, worn or diseased knee with an artificial joint.

It’s a routine operation for knee pain most commonly caused by arthritis.

More than 70,000 knee replacements are carried out in England and Wales each year, and the number is rising. Most people who have a total knee replacement are over 65 years old.

For most people, a replacement knee lasts over 20 years, especially if the new knee is cared for properly and not put under too much strain.

TYPES OF SURGERY

There are two main types of surgery, depending on the condition of the knee:

• Total Knee Replacement (TKR) – both sides of your knee joint are replaced
• partial (half) knee replacement (PKR) – only one side of your joint is replaced in a smaller operation with a shorter hospital stay and recovery period

ARTHROSCOPY

An arthroscopy is a type of keyhole surgery used both to diagnose and treat problems with joints.

It’smost commonly used on the knees, ankles, shoulders, elbows, wrists and hips.

An arthroscopy involves the use of a device called an arthroscope to examine the joints. This is a thin, metal tube about the length and width of a drinking straw that contains a light source and a camera. Images are sent from the arthroscope to a video screen or an eyepiece, so the surgeon is able to see inside the joint.

It’s also possible for tiny surgical instruments to be used alongside an arthroscope to allow the surgeon to treat certain joint conditions.

As the equipment used during an arthroscopy is so small, only minor cuts need to be made in the skin. This means the procedure has some potential advantages over traditional, “open” surgery, including:

• less pain after the operation
• faster healing time
• lower risk of infection
• you can often go home the same day
• you may be able to return to normal activities more quickly

TRAUMA CARE

Trauma and orthopaedics is an area of surgery concerned with injuries and conditions that affect the musculoskeletal system (the bones, joints, ligaments, tendons, muscles and nerves).

You may be referred to a trauma and orthopaedic consultant for treatment of an injury such as a bone fracture, a deformity of the spine or limbs, or a long-term condition that’s developed over many years, such as osteoarthritis.

Orthopaedic specialists treat people of all ages, including:

• newborns and children with deformities – such as congenital dislocation of the hip, club foot and scoliosis
• young people who need joint preserving surgery – such as arthroscopic surgery or osteotomy (see below)
• older people with irreversible degenerative joint problems – who need their joints replacing

ORTHOPAEDIC SPECIALISTS

Most consultants who work in trauma and orthopaedics provide emergency and non-emergency care for musculoskeletal injuries following an initial assessment in accident and emergency (A&E).

They may:

• diagnose injuries or disorders using X-rays, blood tests or other tests
• treat injuries or conditions with medication or surgery
• recommend exercises or physiotherapy to restore movement, strength and functionality

Most orthopaedic consultants also have a specialist interest. This may be a particular orthopaedic condition, a specific area of the body, or a field such as paediatrics or sport surgery.

Adult Degenerative spinal disease:

Adult Degenerative spinal disease:

• Sciatica secondary to lumbar disc herniation
• Sciatica secondary to bony wear and tear changes
• Low back pain
• Neck pain and referred arm pain due to disc herniation
• Cervical spinal myelopathy
• Lumbar canal stenosis
• Cauda equina syndrome
• Osteoporotic spinal insufficiency fracture

Adult Degenerative deformity:

• Sagittal plane imbalance such as spondylolisthesis
• Coronal plane deformity such as degenerative scoliosis

Spinal tumours including:

• Metastatic spinal cord compression (MSCC) for which The Walton Centre is the regional lead
• Neurofibromas
• Schwannomas
• Tumours of the spinal cord, such as intrinsic gliomas, ependymomas and haemangioblastomas
• Primary bone tumours of the spine