Knee arthritis
Knee arthritis is most commonly the result of osteoarthritis (wear, tear and inflammation of the joint). It can result from inflammatory arthritis (rheumatoid, gout); joint damage after an injury/fracture (post traumatic arthritis);
Non-surgical treatment: painkillers, weight loss, low impact exercise, injections.
Partial knee replacement (uni-compartmental knee arthroplasty)
Patients with arthritis involving only one compartment of the knee may be suitable for a partial knee replacement. The inner (medial) aspect of the knee is most commonly affected.
Dr McGonagle will plan your partial knee replacement using dedicated computer software. Dr McGonagle uses implants with a proven track record on the Australian National Joint Replacement Registry and other international joint replacement registries. Implants can be cemented (with polymethylmethacrylate) or uncemented (bone grows onto the roughened surface of the implant).
The advantage of a partial knee replacement over a total knee replacement is that no ligaments are cut during surgery, less bone is cut, it is less painful, recovery is quicker and the knee moves more ‘normally’.
The disadvantage of a partial knee replacement is that the revision rate is higher than a total knee replacement. This is mainly because the rest of the knee wears out over time.
Before Surgery
Blood tests for anaemia, check the result with your GP. Some patients need iron tablets/infusion before surgery.
Preop CT-MRI may be needed if patient specific cutting blocks are used.
MRSA – MSSA swabs: roughly 3 weeks before surgery. If swabs are positive you will get ‘decolonisation therapy’ (mouthwash, body wash, nasal ointment) for 5 days immediately before surgery. This is to help minimize the risk of infection.
Visit the dentist if you have any dental problems.
Make sure you have some family/friends available to provide support with shopping, house cleaning etc. for the first few weeks after surgery.
Dr McGonagle will plan your knee replacement using dedicated computer software. Dr McGonagle uses implants with a proven track record on the Australian National Joint Replacement Registry and other international joint replacement registries. Implants can be cemented (with polymethylmethacrylate) or uncemented (bone grows onto the roughened surface of the implant).
Anesthesia: spinal / general anesthesia, nerve block
During Surgery
A urinary catheter will be inserted into the bladder, to avoid it overstretching whilst the spinal anaesthetic is working
Dr McGonagle will make a cut on the front of the knee, removing approximately 1cm of the femur (thigh bone) and 1cm of the tibia (shin bone), and filling the space with an artificial joint made of metal (often cobalt chrome alloy) and plastic (polyethylene).
There are different ways of planning and performing the bone cuts.
- Conventional: Using rods that are passed inside/outside the bone (intramedullary/extramedullary) to guide the bone cuts.
- Patient specific cutting blocks: A scan of your hip-knee-ankle is performed. Based on these images, a 3-dimensional printer prints a plastic block that is customized for your knee only. These cutting blocks are attached to your knee, and they are used to guide the bone cuts.
- Computer navigated: pins are inserted into the thigh bone (femur) and shin bone (tibia). Sensors attached to these pins feedback to a computer display and guide the surgeon in making the bone cuts.
There are pros and cons to each technique. Dr McGonagle is happy to discuss which technique will best suit your knee.
After Surgery
Day 1 - urinary catheter will be removed.
Bloods and x-ray.
Mobilise with physiotherapist using a frame or crutches.
Use a minibike every day. These will be available on the ward. They can be purchased from Dr McGonagle’s office for you to take home.
Duration in hospital: 2-3 days
Medication to prevent blood clots for 2 weeks after surgery.
Practice nurse wound check at 2 weeks.
Review in Dr McGonagle’s clinic with x-ray at 6 weeks.
Rehabilitation:
Daily use of a mini exercise bike is strongly recommended, plus exercises to bend and straighten the knee to minimize stiffness (mini exercise bikes available for purchase at LMcG Orthopaedics consulting rooms). Regular painkillers will be needed for a few weeks after surgery.
Patients often return to work about 6 weeks after surgery.
Make sure you have some family/friends available to provide support with shopping, house cleaning etc. for the first few weeks after surgery.
Total knee replacement (total knee arthroplasty)
Dr McGonagle will plan your total knee replacement using dedicated computer software. Dr McGonagle uses implants with a proven track record on the Australian National Joint Replacement Registry and other international joint replacement registries. Implants can be cemented (with polymethylmethacrylate) or uncemented (bone grows onto the roughened surface of the implant).
Before Surgery
Blood tests for anaemia, check the result with your GP. Some patients need iron tablets/infusion before surgery.
Preop CT-MRI may be needed if patient specific cutting blocks are used.
MRSA – MSSA swabs: roughly 3 weeks before surgery. If swabs are positive you will get ‘decolonisation therapy’ (mouthwash, body wash, nasal ointment) for 5 days immediately before surgery. This is to help minimize the risk of infection.
Visit the dentist if you have any dental problems.
Make sure you have some family/friends available to provide support with shopping, house cleaning etc. for the first few weeks after surgery.
Dr McGonagle will plan your knee replacement using dedicated computer software. Dr McGonagle uses implants with a proven track record on the Australian National Joint Replacement Registry and other international joint replacement registries. Implants can be cemented (with polymethylmethacrylate) or uncemented (bone grows onto the roughened surface of the implant).
Anesthesia: spinal / general anesthesia, nerve block
During Surgery
A urinary catheter will be inserted into the bladder, to avoid it overstretching whilst the spinal anaesthetic is working
Dr McGonagle will make a cut on the front of the knee, removing approximately 1cm of the femur (thigh bone) and 1cm of the tibia (shin bone), and filling the space with an artificial joint made of metal (often cobalt chrome alloy) and plastic (polyethylene).
There are different ways of planning and performing the bone cuts.
- Conventional: Using rods that are passed inside/outside the bone (intramedullary/extramedullary) to guide the bone cuts.
- Patient specific cutting blocks: A scan of your hip-knee-ankle is performed. Based on these images, a 3-dimensional printer prints a plastic block that is customized for your knee only. These cutting blocks are attached to your knee, and they are used to guide the bone cuts.
- Computer navigated: pins are inserted into the thigh bone (femur) and shin bone (tibia). Sensors attached to these pins feedback to a computer display and guide the surgeon in making the bone cuts.
Dr McGonagle has used all these techniques in the past. There are pros and cons to each technique. Dr McGonagle is happy to discuss which technique will best suit your knee.
After Surgery
Day 1 - urinary catheter will be removed.
Bloods and x-ray.
Mobilise with physiotherapist using a frame or crutches.
Use a minibike every day. These will be available on the ward. They can be purchased from Dr McGonagle’s office for you to take home.
Duration in hospital: 2-3 days
Medication to prevent blood clots for 2 weeks after surgery.
Practice nurse wound check at 2 weeks.
Review in Dr McGonagle’s clinic with x-ray at 6 weeks.
Rehabilitation:
Daily use of a mini exercise bike is strongly recommended, plus exercises to bend and straighten the knee to minimize stiffness (mini exercise bikes available for purchase at LMcG Orthopaedics consulting rooms). Regular painkillers will be needed for a few weeks after surgery.
Patients often return to work about 7 weeks after surgery.
Make sure you have some family/friends available to provide support with shopping, house cleaning etc. for the first few weeks after surgery.
