Knee and ACL Pain
Consultant orthopaedic surgeon, Mr James Owen, has run the Oxfordshire Knee Clinic at The Foscote Hospital in Banbury for the past 15 years. Following studies at Cambridge University and specialist training in the UK, USA and Australia he has gained extensive experience in treating all types of sports knee injuries and provides a comprehensive range of treatments for arthritis of the knee and hip.
Knee arthritis is very common but when is a joint replacement considered?
We all have different expectations and demands on our joints, so what is right for one patient may not suit another. However, a good rule of thumb is that if your knee arthritis is causing significant pain that is not being controlled by simple measures like regular painkillers, gentle exercise and weight loss, and it is interfering too much with your lifestyle, sleep and quality of life, then joint replacement surgery should be considered.
Are some knee replacement joints better than others?
There are several makes on the market but they are all very similar and have good results. The most important factor is that the surgery is done well and that patients undergo a rapid recovery program to rehabilitate the joint. My patients undergo minimally invasive surgery, with small incisions closed with dissolvable stitches, so they can forget about the wound and push on with physiotherapy at The Foscote, often on the same day as surgery.
How quickly can patients get back to normal activities?
I would expect most of my patients to spend only 2 or 3 days in the hospital and to be able to manage stairs by the time they leave. They can usually stop using walking sticks within 2-4 weeks, although everyone is different so some patients may take a little longer.
How can we keep our joints healthy?
It’s all common sense, really. Don’t smoke and have a balanced diet and an active lifestyle to maintain a healthy weight. Joints like to move but don’t appreciate being overloaded. There is also a bit of luck involved, too and there is a hereditary element to arthritis. Even as you get older it is important to consider regular exercise, not only for your joints but also for general health. Pilates, for example, is a popular option to keep your limbs and core strong and supple and regular classes in this are available at The Foscote.
Can you continue sport after joint replacements?
Yes, of course. I have patients who regularly ski, play tennis, golf, cycle or swim. One recent patient competes in international athletics! The main purpose of surgery is to allow you to continue to enjoy sports and other favourite activities.
What is the ACL and why is it so important?
The ACL (Anterior Cruciate Ligament) is responsible for a lot of the rotational stability of your knee and, without it, many people have a knee which feels unstable when twisting and turning and can regularly collapse on them. As well as the obvious inconvenience and pain, this can cause significant damage to the knee over time.
How are ACL and other sport-related knee injuries treated?
The ACL is the commonest ligament injury that requires surgery. I fine-tuned my ACL ligament repair techniques working alongside a leading Australian surgeon and have performed this operation on a weekly basis since 2003. This surgery is done as a day case and you can fully weight bear without crutches or a brace from the day of surgery. Meniscal cartilage tears in the knee are also very common and cause the knee to lock or give way. Treatment usually involves a day case knee arthroscopy (keyhole surgery).
So, should all ACL ligaments be reconstructed?
No, only if the knee is giving way and remains unstable after rehabilitation. It depends on the patient’s age and activity levels and the extent of the injury. Some knees just require an arthroscopy to deal with a meniscus tear, then the patient can cope very well despite an ACL tear. Six months of dedicated rehabilitation are needed after an ACL operation so you have to invest time and discipline to get the best results.
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