Knee Reconstruction in Sydney

This is a decision that we arrive at together after discussing your sporting and activity goals. In general, most patients will be able to achieve their goals with hamstring grafts taken from your thigh on the same side as the reconstruction at the time of the surgery. The most recent scientific evidence suggests that hamstring grafts should be combined with a lateral extra-articular tenodesis to reduce re-rupture rates. If you want to return to a high risk sport such as rugby, I will recommend a bone patella tendon bone (BPTB) graft as this is the most robust. For some patients, I may recommend “allograft” which is a donor tendon from another person that has been processed and sterilised.

In general, it will take about 9-12 months to be back at the point where you are ready to return to sport. We will discuss sport specific exercises and I will liaise with your physiotherapist. There will be specific milestones that you need to achieve to progress in your rehabilitation to be able to return to safely to sport, so there is no definitive timeline. For example, if soccer is your sport, you may be interested in reading about the FIFA11+ program which has good evidence in support of preventing ACL ruptures. The risk of re-rupture is highest in the first two years after surgery, particularly in the period returning to sport.

Many will be, particularly those suffered as part of a sporting injury. Others, particularly those without a history of trauma or injury are usually a sign of osteoarthritis. These are known as degenerative tears. Surgery is usually reserved in these cases for meniscal tears that cause symptoms such as locking, clicking, or catching. Otherwise, there is considerable scientific data now to show that routine debridement or trimming of degenerative tears may actually accelerate the progression of osteoarthritis. For these tears, a guided physiotherapy program is the best treatment.

As a general rule, after the second dislocation, but the evidence supporting this strategy is evolving. Many people will only have a single dislocation in their lifetime after a traumatic event, and therefore they do not require surgery. Others may have multiple dislocations, particularly those with anatomic risk factors or lax ligaments, and the fear of dislocation will limit their involvement in sporting activities. Long-term studies show that repeat dislocations predispose to the development of arthritis under the kneecap, the severity of which correlates with the absolute number of dislocations. The most recent evidence suggests that people who have multiple risk factors for recurrent dislocation are best treated as early as possible, sometimes after the first dislocation.