Knee surgery in Enfield

Booking with Kings Oak Hospital knee orthopaedic team gives guaranteed access to expert care across the full range of knee orthopaedic treatments whether surgical or non surgical. Our experts give up front time for patients to discuss their individual concerns about their problem and patients are able to access immediate, specific treatments addressing their individual needs and goals.

Orthopaedic specialists work as part of a team with musculoskeletal physiotherapists interventional musculoskeletal radiologists enabling a holistic package of care for a comprehensive range of knee orthopaedic problems.

Common orthopaedic diagnoses we treat at Cavell Hospital include:

• Knee osteoarthritis
• knee meniscal injuries
• Anterior and posterior cruciate ligament injuries
• Medial and lateral collateral knee ligament injuries
• Osteochondral defects of the knee
• Patellofemoral dysfunctions including Patella tendon tears
• Anterior knee pain
• Biomechanical dysfunction causing knee pain 

Orthopaedics is a surgical specialty which deals with the accurate diagnosis, assessment and treatment of the joints, muscles and tendons, bones and other related structures. Knee surgery is a complex area and treats problems relating to acute knee injuries as well as degenerative conditions affecting the knee.

Due to the significant reliance of the knee on soft tissue structures including the ligaments and tendons to provide strength and stability to the knee during every day tasks as well as sporting activity. This means treatments for knee pain often involve non surgical physiotherapy intervention or significant periods of rehabilitation post operatively:

• Knee proprioception exercises
• Knee range of motion exercises to regain lost flexibility
• Patellar tendon loading progressions
• Muscle flexibility work 
• Strength work and rotational control exercises raging the hip and knee

In cases where there have been limited benefits with physiotherapy or injections or where there is a clear structural need for surgery on imaging identified the following orthopaedic surgeries may be offered:

• Keyhole meniscus surgery; This may involve repairing a torn meniscus or transplantation of a new meniscus where appropriate 
• Anterior cruciate ligament reconstruction; This may be done with a graft from the hamstrings or in some cases a donor graft 
• Knee preservation surgery; This may involve cutting and realigning the lower leg bones to reduce forces on a worn part of the knee or repairing defects in the joints surfaces (cartilage surgery) 
• Total knee replacement surgery (TKR); New techniques ensure that he metal components used may be custom manufactured to suit each patient’s anatomy

Traditionally, orthopaedic injections for knee symptoms have involved injecting corticosteroid but novel technology enables knee specialists to offer specific constituents of a patients blood involving factors which assist healing. These platelet rich plasma (PRP) injections can be offered in certain situations to optimize knee tissue healing. 

Consultation with a knee orthopaedic specialist will involve a careful period of history taking followed by an in depth knee examination to determine a probable diagnosis and any contributory factors to the problems. Certain factors will be considered by a knee specialist when taking a history:

• Duration of symptoms and any previous treatment for knee pain. This will give an indication of the probability of the problem responding to certain treatments
• Details about knee trauma to cause the pain. Knee trauma is a common sporting occurrence and the exact mechanism including the direction of force, any swelling noted may give a good indication of the structures injured
• Additional symptoms may include locking is there is any significant joint surface (cartilage) defect or meniscal injury. Instability and swelling may be associated with a variety of ligament injuries or joint surface/ meniscal problems
• Screening for any lumbar spine or hip pathology which can both refer pain to the knee
• Intensity of the pain and goals including any day to day or occupational limitations or inability to participate in normal sports related activities

Due to the reliance on the soft issue stabilizing structures a knee examination will often focus on detecting any problems with each structure with special tests:

• Assessing cruciate ligaments stability with special tests
• Assessing any side to side instability to assess the medial or lateral collateral ligament stability
• Meniscal special tests
• Palpating the joint lines and knee cap (patellofemoral joint) for area/s of tenderness
• Observing any swelling biomechanical faults in standing and lying
• Assessing the hip and knee range of motion
• Physiotherapists may conduct some movement and functional strengthening screens which provide some feedback concerning any underlying cause for certain types of knee pain 

Following a knee pain consultation, our orthopaedic surgeons will discuss the likely diagnosis, what the likely treatments options may be, and the best way of managing the problem including the most appropriate imaging techniques for the knee:

• Specialist X-rays. Especially useful for assessing knee osteoarthritis, alignment in standing.
• CT scans – Excellent when a more detailed 3D representation of the pelvic anatomy may be required.
• MRI scans – Knee joint surface, meniscal injuries and knee ligament injuries are reliably confirmed on MRI imaging 
• Ultrasound scans – Excellent for assessing soft tissue structures such as the patellar tendon and surrounding structures 

Usually a combination of those modalities will be used to guide the most accurate diagnosis. Post imaging the value of seeing a specialist is that they can then interpret the scans with their patient (by matching symptoms with the scan findings) to come up with a logical diagnosis. 

Knee replacement surgery £12,650

You can also spread the costs of your treatment with Chrysalis Finance.

Accessing our knee orthopaedic specialists give the advantage of getting word class surgical opinions on a comprehensive range of knee conditions without any waiting list. Our multidisciplinary team also communicates seamlessly regarding your care throughout your journey eliminating any frustrating waiting following inter-hospital referral between our team. 

A further key advantage is when being treated under The Cavell Hospital you will have the time and space to get the full information regarding your condition from one of our orthopaedic specialists at the commencement of your care. Once under a specialist, you will have access to them as required until you have completed your care and are satisfied with your outcome.

Our surgical expertise allows us to offer a fully comprehensive list of options for all eventualities. Particularly useful is our ability to offer patient-specific knee joint implants (for total knee replacement surgeries) rather than traditional off the shelf joint implants. With traditional prostheses there are compromises to be made. Due to the generic shape, traditional implants do not behave like the original joint did due to the mismatch between a patient’s own anatomy and biomechanics and that of the implant.

Our custom fit knee joint replacements are created by taking precise measurements for each patient with unique 3D CT scanning technology ensuring a perfect fit. Due to this fit, made to measure knee replacements have a better functional outcome for patients and have a reduced post operative complication rate.