improvement with physiotherapy and medications. In some cases, for example certain fractures, such as displaced fractures, surgery restores fracture alignment and improve outcomes. Doctors often tend to treat knee pain with medication or therapy. Doctors recommend surgery when the knee condition does not improve with alternate treatments. Knee surgeries are generally safe and low risk. Most patients opt for surgery to return to their active lives, while others delay it for as long as possible.
It is better to consider the pros and cons of knee surgery to make a rational decision.
Advantages Of Knee Surgery
Every surgery has both benefits and risks for patients. Likewise, there are some pros and cons of knee surgery as well. If done with the right indications, knee surgery can allow a quick resolution of knee pathology and restore one to normal functional activity. The following are the major advantages of knee surgery:
Persistent pain and swelling in the knee joint is usually triggered by mechanical issues within the knee joint, such as tears in the meniscus, cartilage and ligaments, which in turn result in inflammation Some of these issues cannot be resolved reliably by non-surgical treatment. If the knee joint is experiencing continuous pain and swelling due to these mechanical issues, then surgical treatment is a reliable method to relieve these symptoms.
Knee Surgery can be Minimally-Invasive
Most modern knee surgeries are done through minimally invasive approach or arthroscopic approach. In arthroscopic knee surgery, only two small 1-cm incisions are required; one for the arthroscope (camera) and one for the other equipment to fix the problem. With open knee surgery such as knee replacements, these can be via minimally-invasive approach through a 10-12 cm incision with minimal involvement of the tendon/muscles. Skin closure is done with absorbable invisible sutures (thought knots might need to be removed at 2 weeks).
Most knee arthroscopy surgeries are done as Day Surgery. The patient can move around immediately after surgery (though might need the help of crutches). Once the knee pathology is resolved, the patient is able to use the knee with more confidence and this is incredibly helpful for athletes who need quick recovery to get back into their games.
Certain knee pathology such as displaced meniscus tear may cause a block to knee movement, severely affecting knee mobility. Once these issues are resolved through knee surgery, the knee mobility would be much improved, and the patient can then return to work and enjoying their sports.
With minimally invasive or arthroscopic techniques, there would be less scarring. With improvement in surgical technique, smaller instruments and an experienced knee surgeon, we can often achieve our surgical aim with keyhole incisions. These incisions result in less scarring, better cosmetic appearance. Without a big scar, patients have better mobility, and less pain and stiffness.They also gain more confidence, and may experience better knee function.
Reduced risk of infection
In arthroscopic knee surgery, less internal tissue is exposed because of the small incisions, which significantly lowers the risk of infection. Our knee surgeons are well trained, and familiar with the best practices to reduce infections.
Less postoperative pain
Any form of surgery results in pain and discomfort. However, there is significantly less postoperative pain in the case of keyhole knee surgery since the incisions are so small. Having lesser pain would mean lesser requirement for painkillers, thus less risk of adverse effects from painkiller medications
Disadvantages Of Knee Surgery
Most patients recover after an arthroscopic knee surgery or a knee replacement, but some suffer complications. So, it is better to have a complete knee evaluation before you opt for surgery. The following are some possible risks of knee surgery:
After knee surgery, some patients also report stiffness which restricts free movement and other physical activities. Thus complying with post-op rehabilitation is very important. If you follow the rehabilitation program after surgery, risk of stiffness is minimal.
There is a small risk of wound infection associated with any surgery. With modern techniques, and sterile procedures, the risk of infection is very low. Our surgeons are familiar with the best practices to reduce infection. Good surgical, use of prophylactic antibiotics, and good wound care are some basic practices we will implement at our clinic to reduce the risk of infection. Our clinic mobile is accessible to you even after office hours, and you will receive prompt response and attention. With these measures, we are confident of providing a high standard of orthopaedic care at our clinic.
Though most patients get rid of pain, there is a small chance that the patient still has some discomfort around the knee or have some scar sensitivity. Participating with physiotherapy, and being able to reach your surgeon will give you the confidence that everything is fine, and the pain you experience is part of healing.
Deep Vein Thrombosis (DVT)
There is a risk of DVT, which is having a blood clot form in one or more of your body’s deep veins. A blood clot can enter the lungs through the bloodstream and restrict blood flow, known as a pulmonary embolism. These risks are usually very low with keyhole surgery. We will initiate early mobilization, early weight bearing, and early range of motion to mitigate these risks. Participating in regular physiotherapy post surgery will also help to reduce the risks of venous thromboembolism.
Damage to Nerves, Tendons and Ligaments
Ligaments provide important stability for the knee, and tendons provide stability for the knee. In rare cases, these can be injured during surgery, resulting in discomfort, limited motion, and instability. Having an experienced surgeon who is well trained will reduce these risks. Talk to your surgeon before your procedure and ask how he can reduce these risks.
Need second, or revision, surgery
If the surgery is a knee replacement, after 20-30 years, the plastic insert between the metal components, also known as polyethylene, may wear out and result in implant loosening, requiring another surgery. For surgery such as ACL reconstruction, the new reconstructed ligament may get torn or ruptured if the knee is subjected to a forceful twisting action. Where repeat surgery needs to be done, it is imperative to find a clinic and surgeon that has the experience to help you, as revision surgeries are complex with significant risks.
The patient may get some giddiness and vomiting as a resulting of the anaesthetic drugs. There is a small risk of cardiac complications and stroke. The evaluation of a patient and his/her fitness for surgery takes place before surgery. Sometimes surgery may need to be delayed, so that the optimization of certain medical conditions such as uncontrolled hypertension can occur, so as to reduce anaesthetic risks.
Consult With Doctor And Decide!
Consider the pros and cons of knee surgery before making a decision. Consult the experienced orthopaedic surgeons at knee surgery Singapore to get back to your active life.