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A knee fracture involves the breakage of bones within the knee joint, presenting as distinct types based on their anatomical location:
A knee fracture is characterised by intense pain, primarily localised in the groin area and upper thigh. This level of pain typically prevents weight-bearing on the affected leg, making movements exceedingly uncomfortable. While individuals may still retain ankle and toe mobility, the capacity to bear weight can be severely hindered. In certain situations, bearing a portion of the body’s weight might be physically possible, yet it can result in significant discomfort and pain.
Knee fractures often result from accidents that lead to falls, particularly in elderly individuals and those with conditions like osteoporosis or weakened bones.
In some cases, knee fractures can occur even without a fall, commonly referred to as spontaneous fractures. These fractures can happen during everyday activities like walking or standing, often affecting the femoral neck. Spontaneous fractures occur primarily in two distinct groups of patients: the very active young and the elderly.
Stress fractures are another concern that arises when people engage in repetitive, high-impact activities while having a weakened leg. This is commonly observed in activities such as running. Individuals taking medications for osteoporosis or engaging in intense physical workouts are particularly susceptible to stress fractures.
Severe trauma, like falls from great heights or extreme accidents, can lead to rare femur head fractures.
The most prevalent types of knee fractures include intertrochanteric and femoral neck fractures. While femur head fractures are less common, they can occur due to intense traumatic events such as falling from a great height.
Most knee fractures need to be surgically treated within 1 to 2 days of injury. However, some non-displaced fractures can be managed without surgery, and certain patients may not recover quickly enough for immediate surgery.
Non-surgical treatments often include the use of crutches for a variable period, which depends on the severity of the injury. This approach is suitable for patients who are unable to walk before surgery or those with serious medical complications.
Displacement fractures of the femoral neck can be more challenging to treat non-surgically. This complexity arises from the involvement of the posterior capsule, which supplies blood to the femur’s head. When displacement occurs, this essential blood supply is compromised, leading to impaired healing and diminished prospects for self-repair. Surgical intervention becomes a crucial necessity in such cases to restore blood circulation and enhance the chances of successful healing, ultimately influencing the quality of life for affected patients.
For patients admitted due to knee fractures, comprehensive evaluations, including blood pressure monitoring and organ function checks, precede surgery. After these initial assessments, a brief waiting period may be recommended to uncover underlying issues that might influence the surgical plan. Surgical approaches are tailored based on fracture type, age, and overall health status. Specific surgical procedures will be discussed during appointments, using advanced imaging techniques to ensure optimal outcomes. Several common surgical treatments for knee fractures are outlined below.
Knee Arthroscopy
Arthroscopy is a minimally invasive procedure used by doctors to both diagnose and treat joint pain without resorting to major surgery. Through small incisions, slender instruments are inserted, allowing for visual examination and targeted interventions within the joint.
To learn more about the knee arthroscopy procedure, as well as what you can expect prior to, during, and after the surgery, please visit our Knee Arthroscopy page.
Complex Primary Knee Arthroplasty
A knee replacement is considered complex when there are underlying issues involving the bone or the surrounding soft tissues of the knee joint. Such complexities can arise from various conditions, including knee dysplasia, a fused knee, prior knee fractures, protrusio acetabuli, specific neuromuscular disorders, skeletal dysplasia, and previous surgical procedures involving the knee. Additionally, complications can be exacerbated by factors like obesity, skin ailments, and issues concerning muscle tissue near the intended replacement site.
Advanced technology equips us with optimal and precise preparations for knee replacement surgery. We employ advanced imaging modalities such as CT scans, 3D modelling, EOS scans, and MRIs. These techniques provide a comprehensive understanding of the patient’s anatomical structure before the surgery begins. Employing newer technologies, such as 3D printing, to generate models for surgical planning enhances the accuracy of the procedures.
To learn more about complex primary knee arthroplasty, as well as what you can expect prior to, during, and after the surgery, please visit our Knee Arthroplasty page.
Complex Revision Knee Replacement
For the majority of patients who undergo knee replacement surgery, the implanted prosthesis can last anywhere from 15 to 20 years, and often even longer. However, individuals who initially received their knee replacement at a younger age and led an active physical lifestyle might necessitate one or more revisions to ensure sustained functionality and mobility over the long term.
Revision knee replacements are undertaken when components of an existing knee replacement require modification or replacement. The extent of revision can range from minor adjustments to a comprehensive reconstruction of the entire knee replacement procedure. The specific approach varies based on the condition of the implant between surgeries. In certain instances, extra bone may need to be added if there has been considerable bone loss.
To learn more about complex revision knee arthroplasty, as well as what you can expect prior to, during, and after the surgery, please visit our Complex Revision Knee Replacement page.
Cartilage Grafting
Healthy cartilage from various areas of the patient’s knee or from donor tissue is used to fill gaps in damaged articular cartilage. This procedure aims to address defects or voids in the articular cartilage. This approach is typically recommended for younger patients or individuals with limited areas of cartilage damage.
Osteotomy
An osteotomy entails the reshaping of either the shinbone (tibia) or thighbone (femur) by a surgeon. The purpose is to alleviate pain by redistributing weight away from the compromised section of the knee joint. This approach is typically used in cases of early-stage osteoarthritis that have only affected one side of the knee joint. Osteotomies can greatly improve the function of the knee, allowing patients to regain mobility and enhance their overall quality of life.
Total or Partial Knee Replacement
Total or partial knee replacement, known as arthroplasty, involves the surgical substitution of deteriorated cartilage and bones in the knee with modern joint implants crafted from metal and plastic materials. This procedure leads to enhanced knee functionality, increased mobility, and an overall improvement in the patient’s quality of life.
To learn more about partial knee replacement, as well as what you can expect prior to, during, and after the surgery, please visit our Unicompartmental Knee Replacement page.
For further inquiries or to arrange a consultation, please contact Professor Al Muderis’ office at +61 2 88829011 or book an appointment online.
X-ray facilities at all locations | Urgent appointments available if necessary.
Professor Munjed Al Muderis is an orthopaedic surgeon and a clinical professor at Macquarie University and The Australian School Of Advanced Medicine. He specialises in hip, knee, trauma and osseointegration surgery. He is a fellow of the Royal Australasian College of Surgeons and Chairman of the Osseointegration Group of Australia.