Once a patient has been deemed to benefit from knee replacement surgery a surgical plan is formulated. This plan takes into consideration the patient’s knee joint deformity, pattern of knee degeneration, surgical anatomy, previous surgical procedures, medical co-morbidities. Further radiological investigations will likely be required to accurately assess the knee and lower limb deformity. An EOS scan is required in every patient to fully assess the knee deformity. The EOS scan is an imaging test that provides a full-body image of your skeleton in 3D, in your natural standing position. This is achieved with a significant reduction in radiation exposure. The surgical plan for a knee replacement includes the type of knee replacement, surgical approach, type of implants to be used, postoperative recovery and rehabilitation.
In most patients the preferred surgical approach is a medial parapatellar approach which involves entering the joint space on the inner side of the patella (“knee cap”). There are though a significant number of patients who present with a valgus knee deformity (“knocked knee”) and a lateral parapatellar approach is performed in these patients as this approach provides a more reliable reconstruction of the patella tracking mechanism.
A knee replacement is a straightforward procedure in the majority of cases due to minor bone and joint deformity and preservation of bone and soft tissues. The surgical procedure involves a meticulous technique that is combined with computer navigation and robotic surgery to deliver best surgical outcomes. There are however, a significant number of patients that present with marked bone and joint deformity, soft tissue deficiency, muscle weakness that require specialized surgical intervention. In some of these patients bony correction of the deformity is required prior to knee replacement, other patients may require constrained implants and some patients require customized implants that match their individual anatomy and restore the anatomy, limb length and joint range of motion. The surgeons at the Limb Reconstruction Centre have extensive experience and expertise in managing the most complex knee joint deformities and have a proven track record of excellent outcomes even in these most complex cases.
