Knee

Knee Arthritis Treatment in Sydney

The knee joint is lined by articular cartilage: a specialised lining which normally allows smooth, pain-free motion. A degeneration or wearing out of this lining results in the bone ends rubbing on each other instead which causes pain.

Non-operative options are aimed at providing symptomatic relief and improving your quality of life. They can be used as a standalone treatment or in conjunction with surgery.

No Gap Billing – Sydney Orthopaedic Surgeon

Dr Rimmer offers no gap orthopaedic surgery to all his patients with private health insurance. This ensures great value and savings to patients who pay a substantial amount to insure themselves and their families.

If you have severe arthritis of the knee causing pain and limitation of your activities and lifestyle and it has not responded to conservative treatments, you may be a candidate for knee replacement.

What are the different types of knee arthritis?

Osteoarthritis

Osteoarthritis is the most common form of arthritis which can be due to normal ageing or may develop as a result of another condition, past surgery or trauma. Osteoarthritis is a condition in which the joint articular cartilage is gradually worn away. The pain tends to be worse in the mornings and with vigorous activity.

Primary osteoarthritis is commonly associated with ageing and general degeneration of joints.

Secondary osteoarthritis is generally the consequence of another disease or condition, such as repeated trauma or surgery to the affected joint, or abnormal joint structures from birth.

Inflammatory Arthritis

The most common form is rheumatoid arthritis an immune disorder resulting in an inflammation of the synovial lining of the joint which releases chemicals and can subsequently damage the articular surface. Knee replacement is only required when there is severe damage to the joint. This condition can affect any synovial joint in the body and is best treated medically by a rheumatologist.

What are the symptoms of knee arthritis?

Pain, swelling and stiffness are usually symptoms of knee arthritis. As arthritis progresses the joint eventually becomes more stiff and swollen and it may be difficult to straighten or bend the knee. These symptoms may be associated with limitation of walking due to either pain, fatigue or swelling.The inflammation might also make the joint feel hot and red. Sometimes, the leg can even change shape (become more bow legged or knock kneed).

What investigations are used in the diagnosis of knee pain?

  • Imaging tests:
    X-rays, magnetic resonance imaging (MRI), and computed tomography (CT) scans can determine the extent of bone damage and if the disease has spread to the surrounding tissues.
  • Bone scan:
    A small amount of radioactive material is injected into a blood vessel and collects in the bone. A special camera takes pictures of the affected areas of bone.
  • Biopsy:
    A tissue sample is removed and sent for microscopic examination to rule out the presence of cancer cells in the bone.

Treating knee pain with medications

Medications used in the management of knee pain and arthritis include:

  • Non-steroidal anti-inflammatory drugs
  • Weak and strong opioids
  • Disease modifying anti-rheumatic drugs and biological agents

Treating knee pain without surgery

Before considering surgery, patients can trial lifestyle modifications and rehab programs.

  • Weight reduction
  • Physical exercise
  • Transcutaneous electrical nerve stimulation (TENS)
  • Thermotherapy
  • Acupuncture
  • Massage therapy

Knee surgery options

Knee arthroscopy

This is a minimally invasive surgical procedure in which a miniature telescope-like instrument is passed into the joint so that Dr Rimmer can see the inside of the knee in great detail, and operate through just two small incisions. This can help in early arthritis especially with the sudden onset of symptoms. Often there is an associated meniscal tear or loose flaps of cartilage which can be removed. An arthroscopy is useful in a knee that is not yet bad enough to warrant a replacement.

Knee osteotomy

In this operation, the bone is cut and and realigned so that more weight is taken on the healthy part of the joinr. This procedure is helpful in young active patients who are not suitable for a joint replacement.

Cartilage transplant (matrix-induced autologous chondrocyte implantation)

This is another option for younger patients. In this procedure patients first undergo a biopsy that extracts cartilage-forming cells, called chondrocytes. They are processed and placed onto a collagen membrane in a specialised facility.

On the day of surgery, Dr Rimmer then implants the collagen membrane into the arthritic knee. As you recover from surgery, the cartilage cells regenerate, forming new tissue to replace worn-out cartilage.

Knee replacement

Joint replacement surgery can be performed as either a partial knee replacement or a full knee replacement. The option that is most suitable will depend on your individual circumstances.

Depending on the size of your knee, the degree of arthritis and deformity, and the amount of preoperative stiffness, you may be a candidate for minimally Invasive surgery (MIS). This technique minimises surgical trauma to the quadriceps tendon and allows for faster recovery of strength, improved mobility in the first few weeks and sometimes less pain. Dr Rimmer will discuss your knee replacement options during your initial consultation.

If you or someone you know has knee arthritis, book an appointment with Dr Rimmer to have your situation properly assessed and managed.