While few patients are likely to relish the prospect of spending time in an operating theatre, most still tend to be grateful when it’s all over and they have recovered sufficiently to begin enjoying the subsequent benefits that are the flip-side of their ordeal. For anyone may suffer a severe trauma, such procedures could save a limb or even a life. However, in a growing number of cases, elective knee surgery is also proving to be a life-changing experience.
Of the 360 joints present in an adult human body, many are incapable of movement and those which are can take a variety of forms. The knees operate like hinges in that their movement is restricted to a single plane, rather like a door or a car bonnet. That said, these hinge joints are of a complex structure that, under normal circumstances, is intended to ensure friction-free action. The joint in question consists of three bones: the femur, the tibia, and the patella. Any of these three bones could become a target for knee surgery due either to an injury or disease.
The main point of articulation is between the two long bones. Consequently, the heads of both femur and tibia are covered with a protective layer of cartilage and, together with the patella, they are enclosed in a membrane filled with viscous synovial fluid which serves to keep the internal structure lubricated. In many cases, these joints will remain fully functional well into old age and often for a lifetime. In other cases, however, knee surgery can often be the only means to ensure a subject’s long-term mobility.
Jointly responsible for enabling us to walk, run and kneel, the knees must also support the weight of our bodies and, during the average lifetime of an active individual, will be subjected to a lot of wear and tear. Even during routine activities, accidents can and do occur, but they tend to do so even more frequently in the case of those who play sports and are prone to overdoing things. In the case of the sports enthusiasts, some form of knee surgery will often be necessary to perform repairs to a damaged meniscus or anterior cruciate ligament (ACL).
Where, once, performing these procedures would have required a large incision to expose the entire joint, this is no longer necessary. The development of the first arthroscope provided surgeons with a means to inspect the interior structure of a joint through a single, tiny incision. Though first used for diagnostic purposes, arthroscopy was quickly adopted by orthopaedic specialists as a means to guide their use of instruments inserted through additional small incisions to perform surgery on the knee and other joints.
While this minimally invasive technique requires considerably more skill on the part of the surgeon, it has been widely adopted within the profession and holds several significant advantages for the patient. Firstly, it can allow both diagnosis and treatment to be completed in a single theatre session. More significantly, arthroscopic procedures tend to result in less post-operative pain while speeding recovery time and reducing the risk of infection when compared with conventional open knee surgery.
Orthopaedic applications for this type of endoscopic keyhole surgery were initially restricted to relatively simple treatments such as repairs to damaged cartilage and ligaments, draining excess synovial fluid and irrigation of the joint to remove loose fragments of cartilage or bone. Since then, however, surgeons have developed new techniques that have enabled them to perform more complex procedures. These include the partial or total replacement of a damaged joint with one or more suitable prosthetic components.
In light of a significantly increased incidence of osteoarthritis and the higher frequency among younger subjects, the demand for knee surgery has also been growing. It is fortunate, therefore, that South Africa has surgeons skilled in both conventional and minimally invasive orthopaedic procedures.
If you wish to learn more about this specialised field or wish to make an appointment with Dr Jan de Vos, contact us at 012 807 0335 or send an email to email@example.com.