Not all knee replacements are equal! Many of the most commonly used designs both in the NHS and in Private healthcare are surprisingly old-fashioned and were designed in the 1980s. If you were looking for a new car you would probably not choose one from the 1980's! It is perhaps no surprise then that on average about 20% of people are not happy with their knee replacement.
Things have moved on since then and our understanding of how the knee works is not much better. More modern knee replacement designs take this better understanding into account in order to make the knees work better so patients are happier.
Mr Willis-Owen is an unashamed perfectionist and does not think a 20% dissatisfaction rate is acceptable. As a result, he is very interested in high-performance knee replacements and has been investigating these and using them for some time.
If you are due to have a knee replacement you may want to check which type your surgeon plans to use, and do a bit of research.
Part of the solution to getting a better knee is the shape of the knee replacement. The knee is a very complicated shape and so far knee replacements have not come close to mimicking this. Modern research has more accurately defined how the human knee works, and more modern implants come closer to copying the complicated movement patterns.
Mr Willis Owen has been most impressed with a Knee called Persona which is a modern design specially shaped to make the replaced knee feel more natural. Mr Willis-Owen has carried out many of these new high-performance knee replacements and been impressed every time with how natural the knee feels compared to a standard total knee replacement. Patients have typically got off crutches sooner, moved the knee more freely, and enjoyed the better function. He has seen amazing results with people in the eighties getting back skiing and many patients enjoying sports again.
There are hundreds of different brands and types of knee replacement and often the NHS ones are understandably at the most cost-effective end of the spectrum. Charles believes that if you are going through the disruption and expense of a new knee it makes sense to use the best modern designs, with the widest range of sizes and the bast chance of a good result!
At the Nuffield Hospital in Bournemouth, we have a Mako robot for robot-assisted partial and total knee replacement. This allows to take a preoperative CT scan to model the knee, then plan where to put the knee replacement on a computer. We then carry out the surgery using a robot and can make adjustments to the position on the computer to see how the changes will male the knee tighter or looser at various parts of the arc of motion. One we have it perfect, we then use the robot to trim away the bone to the nearest millimetre or degree to position the new knee perfectly. This is a well-established technique used over 80,000 times around the world, but quite new to the UK, with ours being the fourth robot to arrive in the country. The new knee position is more precise and recovery is more comfortable and quicker. It also reduces the likelihood that the knee is implanted in the wrong position, and therefore should translate into amazingly good knees!