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Knee surgery and treatment at the London Bridge Hospital
The London Bridge Hospital provides a highly specialised service for the rapid diagnosis and treatment of knee pain, knee injuries and other knee problems. Investigations such as MRI and x-rays can usually be arranged on the same day as the consultation and treatment, including surgery if necessary, can be arranged with a minimum of delay.
Treatments available include physiotherapy, knee injections and knee surgery such as daycase arthroscopic surgery, cartilage cell implantation, total and partial knee replacements.
The London Bridge Hospital undertakes a large number of different types of knee procedures which include:
Arthroscopic trimming or repair of a torn meniscus
A "torn cartilage" is one of the commonest of knee injuries. Where at all possible the cartilage tear is repaired by inserting sutures through keyhole surgery. Where repair is impossible the least amount of cartilage necessary to abolish pain and clicking is trimmed. In some cases a meniscal transplant can be performed to replace badly damaged meniscus.
Arthroscopic removal of plicae and loose bodies
The knee joint has a lining known as the synovium which secretes a lubricating and nutrient fluid into the joint. A fold of the synovium known as a plica can get trapped in the joint causing pain, swelling and clicking. These plicae are easily removed using keyhole surgery. The same technique is also used to remove loose fragments from within the joint.
Removal of bony spurs
Bony spurs or "Osteophytes" can form at the margin of the knee joint and cause pain and limitation of movement. These can be shaved arthroscopically and can be readily removed during daycase surgery with improvement in pain and joint function.
Arthroscopic anterior cruciate ligament reconstruction
Reconstruction of the cruciate ligament is frequently required following skiing, football, netball and other sporting injuries. The repair is performed through tiny incisions using keyhole surgery. Two of the hamstring tendons are removed through the same incision and used to replace the cruciate ligament. Less often, posterior cruciate reconstruction is required.
Autologous cartilage-cell implantation
Where there has been loss of articular cartilage they are sometimes able to take a sample of normal cartilage cells from the knee joint, have a sheet of new cartilage grown in the laboratory and then reimplant this to resurface cartilage defects within the knee joint. This forms part of a clinical research project.
Primary total knee replacement
In cases of advanced damage the knee joint total knee replacements are performed using a minimal blood loss technique without the need for blood transfusion or the need for a tourniquet. In most cases an excellent range of movement is achieved with good return of knee function and pain relief.
Primary unicondylar knee replacement
About half of their knee replacement cases require only a part of the joint to be replaced, most commonly the inner or medial compartment and less commonly the outer or lateral compartment. Functional outcomes are often near normal with excellent return of function in most cases. Many such patients regain a very high level of mobility.
Revision knee replacement surgery
Where a previous knee replacement has failed or has never functioned well revision knee replacement is performed with in most cases extremely beneficial return of function. These are complex cases which require significant surgical expertise and careful post-operative rehabilitation. These cases are also undertaken without tourniquet and in many cases without a need for transfusion.
Injections into the knee are commonly required on an outpatient basis for pain relief in arthritis of the knee using a material known as Hyaluronan. This used to be called Hyaluronic Acid but is in fact a chain of 10,000 or more pairs of sugar molecules one of which is a form of Glucosamine. This functions as a lubricant and has many other important physiological and nutritional effects on the joint.
Inpatient and outpatient physiotherapy is available on site to cater for all your requirements either as the main modality of treatment and also before and after surgical intervention.
They also work with, and have links with, numerous independent physiotherapists specialising in the treatment of knee problems in many areas of the UK. In London they have close links with ES Physical Therapy at Harley Street for isokinetic assessment and treatment.
If you have your own physiotherapist they will be happy to refer and liaise with him/her and to send them all details of your diagnosis, clinical assessment, operation details and post-operative care.