Knee replacement may not be your only treatment option

"Knee operation gave me a new lease of life" says Shalbourne patient

Most of us know someone who has had a knee replacement. Knees are subject to a lot of wear and tear as we age, and are also quite easily injured if we inadvertently move awkwardly, so it’s no surprise that some of us need surgical help.

But perhaps fewer of us realise that a replacement knee joint is only one of many procedures available to patients who experience cartilage problems.

Articular cartilage is the tissue that covers the ends of our bones where they form joints. It allows bones to glide over each other smoothly, with little friction. Cartilage does not contain blood vessels, and severe cartilage damage doesn’t normally heal very well on its own, so surgery is often necessary to get the knee functioning properly again. The decision about which procedure is likely to produce the best outcome for your particular damage, though, is one that you and your consultant will want to consider carefully.

Venkat Satish is a consultant trauma and orthopaedic surgeon at Shalbourne private healthcare in Swindon who has a special interest in treating cartilage problems within the knee.

“We are fortunate at Shalbourne to be able to offer a wide range of procedures for treatment of knee surface damage,” says Mr Satish.

“Some of the procedures are not routinely carried out by the NHS, but we are able to tailor treatment to each individual patient and, where appropriate, use minimally invasive surgery techniques.”

The options for treatment are diverse and many, and include:

  • a form of keyhole surgery known as arthroscopic debridement
  • enabling stimulation of new cartilage by the body’s own bone marrow cells
  • using small plugs of healthy cartilage from non-weightbearing areas of the knee to replace small areas of damaged cartilage
  • repairing damage with a special patch or gel
  • taking a small sample of cartilage cells from the joint which are then used to grow more cells in a laboratory which replace the damaged cartilage.

Shalbourne now also offers a cartilage repair technology called CartiOne, in which some of the patient’s bone marrow cells are mixed with cartilage taken by biopsy from the patient and used to repair damage. Shalbourne is the only private provider in the area that can complete the CartiOne procedure in one session, on site, thanks to the fact that it holds an appropriate tissue licence. This also applies in being able to offer patients the option of ACI surgery.

James Hussey, 62, pictured third from right here, farms on the Marlborough downs. He underwent a total knee replacement in early 2017, and says his quality of life has been revolutionised since.

"Before the operation I was permanently in pain," says James.

"Bending my knee was very painful so using any form of transport became difficult, and I'd stopped walking if I didn't have to, because my knee felt so insecure an dunstable on any downward slope.

"Then Mr Satish carried out the treatment and I could soon see a huge difference, In February this year I was so much better that I did a ten-day trek up Mardi Himal in Nepal with members of my Family, walking six or seven hours most days. We covered 100km distance, and went up several thousand metres - we even used crampons for the final stretch. I've gone back to the activities I used to enjoy, including water-skiing, riding and hiking. And, thanks to the treatment, I was able to get down on one knee and ask my partner Nikki to be my wife!' She said yes and we are now married."

Venkat Satish has been a participating surgeon in a multi-centre long term prospective trial evaluating different techniques of cartilage repair and reconstruction. His military experience gave him wide experience in the management of complex trauma and sports injuries of the lower limb. Mr Satish offers advice and surgey for the fill range of knee problems.