If you haven’t experienced knee pain, it’s likely you will know someone who has. From sports injuries, general wear and tear and ultimately arthritis, knee issues are common and so too it seems is our appetite for surgery - all in the pursuit of saving our mobility.
Dr Stuart MacKenzie is an orthopaedic surgeon specialising in hip and knee surgery and trauma at both Lingard Private and John Hunter Hospital.
Having studied his medical degree at Newcastle University, he completed orthopaedic surgery training in Newcastle before traveling overseas to undertake subspecialist fellowships in hip and knee replacement surgery, working a year in Canada and six months each in the USA and England.
Dr MacKenzie performs a range of knee surgery specialising in knee replacement surgery and sports knee surgery, including total knee replacement and partial knee replacement including robotic assisted total and partial knee replacement and patient specific knee replacement. He also performs knee arthroscopy including arthroscopic anterior cruciate ligament (ACL) reconstruction surgery and specialises in revision or re-do knee replacement surgery and ACL surgery.
While he says that advances in surgical techniques over the years have led to greater accuracy, quicker recovery and a longer life expectancy in knee replacements, surgery is not necessarily always the first step.
“The decision of whether or not to operate is an individual one for each patient. In some cases, a patient’s symptoms may be able to be managed with physiotherapy and pain medication rather than needing a knee replacement.
“Strapping and braces can be helpful for some knee problems and may help prevent injury.
Similarly, a person with an ACL injury may be able to function normally with just physiotherapy and not need surgery depending on the activities they normally do,” he begins.
While not everyone opts for surgery, knee replacements, says Dr MacKenzie are definitely on the increase.
“Knee replacement is definitely becoming more common each year. There’s a number of factors which have contributed to this. The most important is that the population is ageing. The baby boomer generation are coming to the age where they are developing arthritis and might need knee replacement surgery.
“But I also think that people are less prepared to tolerate having their lifestyle affected by the pain and immobility of arthritis knowing that knee replacement might be able to get them mobile again,” says Dr MacKenzie.
With advances in rehabilitation both for knee replacement and ACL reconstruction patients can get back to normal function faster post surgery.
Sports or workplace injuries can lead to the need for knee arthroscopy or ACL surgery due to acute injury in the short term or knee replacement many years later.
Most people needing a knee replacement however, have not had any specific injury to cause their arthritis. Generally, it is just degenerative wear and tear that leads to arthritis and the need for knee replacement. Being overweight can contribute to this degeneration and in some cases losing weight can significantly improve the symptoms.
“It takes 3 to 6 months to fully recover from a knee replacement. Most patients can expect to get back to almost normal function but it requires physiotherapy and hard work. There is no limitation on what you are allowed to do after a knee replacement but running is not recommended,” adds Dr MacKenzie.
The life expectancy of a knee replacement depends in part on how active the patient is and other factors. There is about a 90 per cent chance that a total knee replacement will last 20 years.
For sports players, the time to return to full sporting activity after knee surgery depends on the type of surgery. For a knee arthroscopy for a meniscal tear it can be as short as a few weeks but a full knee reconstruction for an ACL injury takes about 6 months to return to full training and 12 months to return to contact sports. While full normal function resumes there is always a risk of reinjuring the ligament.
Dr Stuart MacKenzie currently works in both the public and private hospital systems. He consults at the John Hunter and Lingard Private Hospitals.