Our consultant knee surgeon Q&A

10 July 2014

At Spire Tunbridge Wells Hospital you can get direct rapid access to our expert orthopaedic consultants.

Our orthopaedic consultants specialise in:

  • Hand and wrist, carpel tunnel, arthroscopy to reconstructive work
  • Hip, minimally invasive hip replacement and revision surgery
  • Knee, whether sports related, arthritic changes or knee replacement
  • Shoulder, keyhole diagnostic procedures to shoulder replacement
  • Back and spine, simple pain management techniques to complex spinal surgery
  • Foot and ankle, from bunions to ankle and reconstructive surgery

Whether you’re insured or not, we’re open to everyone and offer one-off private treatment with a fixed price agreed in advance.

Mr Nicholas Bowman, one of our consultant knee surgeons, discusses the knee joint and related problems he sees in his clinic.

What are the special features of the knee joint?
The knee joint is the largest hinge joint of the human body and has considerable forces exerted on it on a daily basis. Because it is situated between the two longest and strongest bones of the body, it is susceptible to twisting injuries, sideways impact injuries as well as degenerative (wear and tear) disease processes.

What do patients complain of when they have a knee problem?
Symptoms can vary in the knee joint depending on the particular problem that exists. Injuries commonly cause pain around the inner aspect, and may be associated with catching or stabbing pains. Ligament injuries often manifest as knee instability and patients can experience giving way of the knee, or a feeling that the knee can’t be trusted.

Knee cap disorders are often associated with pain at the front of the knee, particularly going up or down stairs or hills. Wear and tear problems are often associated with a persisting ache or discomfort in the knee, usually associated with activity. There may be reduced movement and stiffness of the joint.

What causes knee problems?
The human knee is a complex structure that has many components – any of these component parts can be injured either during sporting activity or in accidents such as slipping, a fall or a twisting injury. Unfortunately, with increasing age, the knee joint can become susceptible to wear and tear (osteoarthritis) which can cause pain or stiffness. Sometimes the knee joint can become painful or stiff without any obvious anatomical injury, disease or internal derangement and can become symptomatic due to weakness in surrounding muscles.

A knee specialist will hopefully be able to pinpoint your particular problem after taking a detailed account of your particular concerns, and a careful clinical examination of you and your knee. Further investigations such as X-rays and MRI scans are usually helpful in confirming the diagnosis and in tailoring specific treatments.

What diagnostic tests do you use?
I like a plain X-ray of the knee in almost all cases. Often an MRI scan is requested, to look at knee structures in more detail. Fractures of the knee are best visualised with a combination of X-rays and CT scans.

When is surgery required?
Thankfully, many knee disorders can be treated without the need for surgery and once a diagnosis has been made, the mainstay of these treatments involve physiotherapy, muscle strengthening and functional rehabilitation.

Some conditions will require surgery and these tend to be significant, higher energy injuries, or disorders that present to a knee specialist at an advanced stage. Occasionally surgery can be indicated if your particular problem fails to respond to non-surgical measures (physiotherapy, osteopathy etc).

When can patients be seen?
I am available to see patients upon request at the Spire Tunbridge Wells Hospital. I also run a specialist Knee Injury Clinic on Mondays.

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