Knee surgery, navigated.
Over 100 computer-navigated total knee replacements every year. Robotic-arm assisted procedures, ACL and patella reconstruction, and high tibial osteotomy for younger patients with partial arthritis.
Expert diagnosis & treatment selection.
From acute sports injuries through to advanced osteoarthritis — meniscal tears, ACL injuries, knee arthritis, patella instability, and worn or painful knee replacements.
Meniscal Tears
C-shaped cartilage shock-absorbers inside the knee. Seven tear types (longitudinal, horizontal, radial, oblique, buckethandle, complex, root). Symptoms include catching, locking, and swelling.
ACL Injuries
The anterior cruciate ligament connects tibia to femur and prevents excessive sliding. Rupture causes instability — audible pop, rapid swelling, feeling of giving way. Reconstruction may be needed for sports return.
Knee Arthritis
Cartilage degradation leading to bone-on-bone surfaces and bone spurs. Localised pain, activity-worsening, sleep disturbance, limping, stiffness, crepitus. Includes stem-cell therapy discussion.
04 · ConditionPatella Instability
Patella Instability
The kneecap dislocates from the trochlear groove (usually outwards). Multiple factors contribute to stability — patella shape, ligaments, quadriceps strength, joint laxity, valgus knees.
Non-surgical: splint, physio, quadriceps (VMO) strengthening, taping for sport return. 60–70% heal without surgery after a first dislocation.
Surgical: arthroscopy for bone fragments, open repair for larger fragments, ligament reconstruction for recurrent instability.
Diagnosis: X-ray, long-leg standing X-ray, MRI, and CT — see also Patella Stabilisation surgery.
05 · ConditionWorn Knee Replacement
Worn Knee Replacement
Knee replacements can fail through six mechanisms:
- Loosening — repetitive stress at the bone-implant interface
- Wear — plastic liner debris triggers an immune response and bone loss
- Infection
- Instability — ligament loosening over time
- Fracture — usually after a fall
- Patellofemoral pain — if the kneecap was not resurfaced
Investigation: X-rays, CT, MRI, bone scan, SPECT CT, ultrasound, blood tests.
Treatment: conservative monitoring or revision knee replacement.
Seven procedures, all subspecialty-trained.
Computer-navigated and robotic knee replacement, ACL reconstruction with hamstring or patellar tendon graft, knee arthroscopy, revision knee replacement, patella stabilisation, and high tibial osteotomy.
Total Knee Replacement
90-minute procedure using computer navigation for precision cutting guides. Most implants cemented with PMMA. Standing same day; full recovery six months.
ACL Reconstruction
Graft from hamstring, patellar tendon, or allograft. Arthroscopic keyhole technique with bone tunnels. Sport return at 12 months; re-rupture rate around 5%.
Robotic Knee Replacement
Robotic-arm assisted guidance for sub-millimetre cutting precision. Used selectively where component placement is anatomically demanding. Pre-operative CT planning informs the robotic-arm cutting plan.
Knee Arthroscopy
Camera and instruments through two to three 1cm incisions under general anaesthesia. Treats meniscal tears, cartilage damage, scar tissue, loose bodies, early arthritis, ligament reconstruction. Same-day discharge.
- ·Meniscectomy & meniscal repair
- ·Chondroplasty & microfracture
- ·Stitches at 10 days; driving 1–2 weeks
- ·Office work 1–3 days; swelling 6–8 weeks
Revision Knee Replacement
Re-doing a failed total knee replacement — for loosening, wear, infection, instability, fracture, or patellofemoral pain. Spinal anaesthesia, 90 minutes to 4+ hours. Specialised revision prostheses (metal augments, bone grafts for bone loss). Hospital 2–7 nights; crutches 6 weeks. Majority experience favourable long-term pain relief and function.
Patella Stabilisation
Indicated after 2–3 dislocations or where cartilage / bone damage has occurred. Two techniques: MPFL Reconstruction — medial patello-femoral ligament reconstruction using hamstring tendon graft, bone anchors and screws. Tibial Tuberosity Osteotomy — repositioning of the tibial tuberosity bone, fixed with 2–3 screws. Recovery: 6 weeks reducing swelling and regaining motion, then strengthening; sport return at 4–6 months. 90–95% success rate.
High Tibial Osteotomy
Realignment of the tibia to redistribute load away from a worn compartment of the knee, preserving the native joint. Indicated for younger patients with single-compartment arthritis and acceptable alignment correction targets. Allows ongoing sport and manual work in a joint that would otherwise require replacement years earlier.
Over 100 computer-navigated total knee replacements every year.
High-volume subspecialty practice produces measurable improvements in implant positioning, alignment, and long-term outcomes. Computer navigation drives that precision in every primary case.