Greetings from Neil Watson
I have been in specialist orthopaedic practice in New Plymouth since 1986, first at Strandon then Fulford St and now Mt Edgcumbe St.
Although I consider myself a generalist orthopaedic surgeon, I particularly enjoy undertaking knee joint replacement surgery.
The lives of elderly patients (and not so elderly) suffering osteoarthrosis can be dramatically improved by knee replacement. Medial compartment 're-surfacing' is applicable in some cases. When patello-femoral pain is present on stair climbing, prolonged sitting, rising from a chair and kneeling, I recommend total knee joint replacement including re-surfacing the patella.
For many years I have used the Nexgen design from Zimmer with a very low revision rate. I employ cementless mode of fixation of the femoral component (which requires accurate milling of the femoral condyles) and more conventional cement fixation of the tibial and polyethylene patella components. Despite considerable pre-op deformity due to varus angulation and fixed flexion deformity, using appropriate releases of collateral ligaments and posterior capsule, I expect to achieve correction of alignment in almost every case. Recovery of a satisfactory range of motion is more difficult to predict because of many patient factors which impact during the post-op phase.
In recent times Computer Navigation promises accuracy in positioning of components at knee replacement. This technique appeals in cases where the normal bony landmarks are distorted but it is equally useful where less anatomical distortion is present and precision is required. Intuitively, if the components are positioned accurately, then the range of motion is expected to be maximal and the longevity of the knee replacement enhanced. This issue is the subject of ongoing study presently.
Computer navigation is now available at Southern Cross Hospital in New Plymouth using Triathlon design from Stryker. I can offer this enhancement to patients who might be interested in the benefits navigation has to offer.