Some Common Reasons for Consulting a Specialist in Knee Surgery

Oct 20, 2017 | Articles

Some Common Reasons for Consulting a Specialist in Knee Surgery

Although most people only become aware of the fact once they experience pain or loss of movement, our joints are subject to extreme stress and strain during the course of an average lifetime. Any tendency to consistently overwork our joints over a prolonged period carries with it the risk of damage to a shoulder, hip, or knee that, in time, could require surgery by an orthopaedic specialist.

For example, anyone who may participate regularly in almost any kind of sports faces the possibility of a joint injury that may require some form of surgical intervention. In addition, the inevitable process of aging commonly results in the condition known as osteoarthritis, due not to extreme activities, but rather to the long-term, general wear and tear experienced over the course of six to seven decades or more.

More recently, however, there has been a marked shift in the age range of those affected by osteoarthritis, with more cases being reported among those in their forties and fifties, or even younger. Adding further to the existing demand on hip and knee surgery specialists, ongoing research suggests that the expanding demographic may be related to the widespread and disturbing increase in obesity, which is resulting in these joints being subjected to greatly increased pressure, even during normally low-stress activities, such as taking a walk. Unfortunately, some of these subjects then take up jogging in order to lose some weight, thus further compounding their risk of joint damage.

The technique of arthroscopy, which provides a means with which to view the internal structure of a joint in real time, has endowed today’s knee surgery specialists with a valuable tool for observation purposes and with which to perform minimally-invasive interventions. This alternative option has meant that procedures that would previously have required general anaesthesia and extensive cutting can now be performed with just a couple of tiny incisions, and can often be conducted with just a local anaesthetic. The subsequent reduction in recovery time is also much appreciated by those patients who may be anxious to resume their normal activities with as little delay as possible.

There are a number of common conditions that can lead to a patient needing to undergo arthroscopy. Also, on occasions, knee surgery specialists may wish to corroborate or to extend the findings of other investigative procedures, such as radiology, magnetic resonance imaging (MRI), and computer-aided tomography (CAT Scans), with an arthroscopic examination in the attempt to ensure an accurate diagnosis. Given the existing incision and the means with which to view the damage already in situ, this raises the possibility of proceeding directly with an appropriate orthopaedic intervention, based on the confirmed findings, thus eliminating the need for a second operation. In such cases, an additional keyhole incision or two, through which to insert any instruments required, will usually prove necessary, but this should not serve to extend the necessary recovery time.

Typically, knee surgery specialists will adopt an arthroscopic approach for the treatment of a tear in one of the menisci, the joint’s twin shock absorbers that act to ease the impact between the heads of the femur and tibia when running, jumping, or carrying a heavy load. Where the cartilage that normally protects the articulating surfaces of these bones is damaged, a repair may also be undertaken arthroscopically, as can the lavage of the joint, when affected by arthritis that can often create loose debris causing grinding and pain upon movement.

Where there is damage to one of either the anterior or posterior cruciate ligament that, together, serve to stabilise the joint, arthroscopy can sometimes be necessary to establish an initial diagnosis. However, it will require a more radical approach by the knee surgery specialist when it is time to perform a reconstruction of the torn ligament.

There are, in practice, a number of joint-related procedures for which arthroscopy is impractical. Of these, the partial or total replacement of a severely damaged joint with a suitable prosthesis that once seemed little short of miraculous has become commonplace during the last decade or two. Today, hip and knee arthroplasty are widely regarded as the most successful of all orthopaedic interventions to date.

That to perform such procedures successfully requires sound surgical skills and extensive experience is a given. Both South Africa’s physicians and many in overseas countries have been quick to recognise these qualities in the Pretoria practice operated by Dr Jan De Vos – an accomplished shoulder, hip, and knee surgery specialist.