Arthroscopic surgery is usually not helpful in the treatment of osteoarthritis itself, but can occasionally be useful for the treatment of associated problems such as large displaced cartilage tears , loose bodies, etc.
The most effective surgical treatment for severe arthritis is Total Knee Replacement (TKR). This involves replacing the worn out surfaces of the joint with metal and plastic surfaces which are similar in shape to the natural joint surfaces and which function in a similar, but not identical way. A TKR never feels or functions completely like a normal healthy real knee, and its purpose is to relieve arthritic pain to allow comfortable walking. Running or jumping on a TKR is not recommended, and most people don’t like to kneel.
Infrequently Dr Kennedy may recommend a “partial” knee replacement in which both surfaces of a limited part of the knee are replaced. This is not often appropriate.
Occasionally, especially in younger patients with osteoarthritis, Dr Kennedy may recommend a different form of major surgery which involves cutting one of the bones close to the knee in order to realign the joint rather than replacing it, this is called an “osteotomy”. Many patients who have an osteotomy will go on to have TKR later in life.
Dr Kennedy routinely carries out TKR using “computer assisted surgery” which allows very accurate restoration of alignment of the whole affected limb, which is usually rendered abnormal by severe knee arthritis. Dr Kennedy always uses the “Nexgen” knee replacement system which is made in the USA by the Zimmer company, and which has been the most reliable system used in Australia for many years.
Knee Replacement surgery is a major intervention not to be undertaken lightly, and carries with it many risks, which will be discussed in detail. The surgery requires admission to hospital for 4-7 days, depending on individual progress which is quite variable. The recovery period is also variable, typically it can be 6-12 weeks before comfort is achieved, and optimum recovery takes many months, involving considerable hard work by the patient (rehabilitation).
It is a common misconception that knee replacements have a 10 year life expectancy, but this is not so, and if early complications are avoided TKR can be very long lasting.