The trouble with knees

Knees have a tendency to catch up with you as you get older!

It’s not just the preserve of the dedicated sportsperson to suffer from pain and weakness in this area but an affliction that many of us will endure.

The good news is that there are huge developments in the procedures and treatments for knee problems that mean that the traditional “one size fits all” approach of replacing part of or the entire knee joint is rapidly becoming the “port of last call”.

Before we talk about what can now be done a little anatomy might help.

Most of us, believe it or not, are slightly bow legged; and most of the remainder are slightly knocked kneed!

What this means to our knees is that one side or the other of the joint is subject to a significant amount more pressure. It is this effect that causes a lot of our degenerative joint problems.


The side of the knee experiencing the greatest pressure will wear out more quickly with the padding (the meniscus) becoming damaged or eroded and the joints becoming more painful.

It is at this point in one’s life that knee surgery becomes a real reality and replacement joints are considered.

But think on what a knee replacement really is – it is an internal amputation of a joint – and any amputation is the last resort.

At Hampshire Knee we are passionate about exploring the new developments and the massive progress that has been made in refining past procedures that now offer alternatives to replacement.

One such procedure is the Osteotomy (which actually existed in a crude form long before knee replacement).

An Osteotomy essentially involves the realignment of your leg to shift the pressure points from the damaged part to the undamaged part of your knee joint.

My team and I have worked hard over the past seven years and coordinated with other knee surgeons around the world to research the challenges faced in turning the Osteotomy operation into an exact science.

Before undergoing an Osteotomy a patient’s leg is given a complete scan from hip to ankle. Then, using computer images, a straight line is plotted between the two joints so that we can judge just how far out of position the knee is.

Technology then maps how the leg needs to be realigned.


Correcting the alignment involves a two-part procedure. First, using keyhole surgery the inside of the knee joint is examined and damaged cartilages can either be removed or tidied up. In some cases steps are taken to encourage the growth of new cartilage or even a new meniscus inserted.

Then having mapped how the leg needs to be realigned our surgeons will operate to slightly alter the shape of the femur (thigh bone) or tibia (shin bone).

In most cases the shin is the target. Taking a point around 5 centimetres below the knee the surgeon reshapes the bone by either making a single cut into it or making two cuts and removing a slice of bone shaped like a small chunk of cheese.

A strong metal plate is inserted using screws to realign the bone so that the patient no longer walks with bowed legs or knock knees and the pressures on the knee joint are released.

The success rate of this procedure is outstanding and enables our patients to lead full healthy and active lives free from the inconvenience of knee pain for many years.


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