The knee is the joint made of the distal femur, the upper tibia and the patella. Intra-articular surfaces are covered by cartilage and the menisci serve to increase the surface contact area between the fenmur and the tibia.

Knee injuries

Ligaments and menisci are often damaged following contact or sudden twisting. Even though a physiotherapy program can reduce pain and improve function, surgery is often needed.

The most common procedure for a torn meniscus is a menisectomy. Removing the torn part of the meniscus is often necessary because the success rate of a repair is low. Menisectomy is performed with a small camera called arthroscope.

Be careful! If the meniscus tear is caused by osteoarthritis, performing a menisectomy is unnecessary and most of the time won’t provide pain relief.

The most commonly torn ligament in need of surgery is the anterior cruciate ligament (ACL). The ACL is repaired or reconstructed with a tendon using an arthroscopic technique.

Knee osteoarthritis (OA)

Osteoarthritis is the destruction of cartilage surfaces. It is sometimes related to injury but most of the time is related to the aging process of the cartilage.

It is not possible to regenerate cartilage. When cartilage degeneration is severe and knee pain gets worse, the surgical procedure of choice is a total knee replacement (TKR) performed with implants made of metal and plastic.

Frequently asked questions

About 85% of patients estimate they are improved following TKR. However, it is unusual that they rate their knee as normal.

The most common complaints of satisfied patient after their surgery are difficulty to kneel, difficulty climbing stairs and presence of pain when making certain movements.

Overall, TKRs are performed in patients 65 years old or older with severe osteoarthritis because implant survivorship is around 20 years. It is hoped that for these patients a revision won't be needed one day.

An increasing number of patients aged between 50 and 65 years old are coming to TKR. The outcomes and implant survivorship of this group of patients are often inferior to the older age group. They are at higher risk of eventual revision surgery. That's why some orthopedic surgeons refuse to perform surgery on these young patients.

It is a rare exception for patients less than 50 years old to receive a TKR. Patients in this age group often have a severe condition like rheumatoid arthritis. It is common for them to be taken care of in university centers.

Yes, but complications and early failure rate is higher in obese patients. That's why it is better to loose weight before surgery and some surgeons refuse to perform surgery on obese patients.

There's no age limit for total knee replacement. To qualify for surgery, general health must be good enough to expect an eventful surgery, and the post-operative goal must be a realistic significant improvement in the quality of life.

Yes. It’s called a Unicompartment Total Knee Replacement (UKR). The knee is divided in 3 compartments : medial, lateral and patellofemoral. The medial UKR is the most commonly performed surgery.

Sometimes yes and sometimes no. It is agreed that a knee cap (patellar) implant is most likely to reduce anterior knee pain after TKR. However, there are complications related to surgery of the patella. That’s why every surgeon has its own indications, often based on experience, to decide when patellar surgery is necessary in TKR.

Yes, this is called a revision total knee replacement. The implants are removed and new, often much bigger, implants are inserted. Bone loss is addressed with modular metal augments. It is a complex surgery where outcome may get close to those of primary TKR when performed by expert hands.