CQ ORTHOPAEDICS
Dr James Roche
Orthopaedic Surgeon
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KNEE ARTHROSCOPY
KNEE ARTHROSCOPY
Knee Arthroscopy is keyhole surgery on the knee. It allows the inside of the knee to be seen with a small 4mm camera and instruments introduced into the knee for therapeutic procedures.
Conditions treated with knee arthroscopy include:
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Meniscal tears
Impingement from synovial folds
Cartilage damage
Infection within the knee
Removal of loose bodies causing locking
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Surgical time is usually around 30 minutes and is carried out as a day case procedure.
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Recovery depends on the treatment carried out. Usually it takes 2-3 weeks for the swelling to settle down and often a full recovery takes less than 6 weeks. If a meniscal repair has been performed you will need to use a knee brace and keep your weight off the knee for approximately 6 weeks.
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ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Knee Arthroscopy is also used in the reconstruction of a ruptured Anterior Cruciate Ligament. The ligament is usually reconstructed using one of the hamstrings tendons that is harvested through a small incision just behind the knee. This is then woven together to form the new ligament. Tunnels are drilled into the correct positions for the new ligament using jigs and special drills under direct vision with the arthroscope.
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You may require a brace following surgery depending whether any other procedures have been carried out in conjunction with the reconstruction (such as a meniscal repair). The surgery is usually performed with a single night stay in hospital.
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Physiotherapy is extremely important for a good result with this surgery. Dr Roche likes his patients to have seen his physiotherapist before surgery and an extensive course will be required after surgery. It takes approximately 9 months of rehabilitation to return to contact sports.
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KNEE REPLACEMENT SURGERY
TOTAL KNEE REPLACEMENT SURGERY
Knee Replacement Surgery is an increasingly common operation and is now performed more commonly than hip replacement. A knee replacement is made of a metal alloy femoral component, a metal tibial component with plastic attached to it and a plastic button that can be attached to the back of the knee cap. The knee can be fixed in place with cement but it can also be cementless depending on the bone quality and demand of the patient.
UNICOMPARTMENTAL KNEE REPLACEMENT SURGERY
Dr Roche has been trained in not only total knee replacement but also unicompartmental knee replacement. This is used in selected patients where osteoarthritis is localised to one area of the knee. Just the area that is affected is replaced - this is usually the medial side of the knee. This results in quicker recovery and better function from the knee.
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Dr Roche uses the Stryker Restoris unicompartmental knee replacement. This can only be implanted with Robotic Assistance and has excellent results in the Australian Orthopaedic Association National Joint Replacement Registry
REVISION TOTAL KNEE REPLACEMENT
Dr Roche has undergone additional training to learn the techniques used in treating infected, painful or worn out knee replacements. This involves investigating the patient to determine the cause of their symptoms and addressing this at subsequent surgery.  It usually involves removal of the original knee replacement and reconstruction using advanced prosthesis to compensate for bone loss or ligament insufficiency.