Knee Preservation Surgery in Adelaide

What knee preservation means

Joint preservation is the part of knee surgery concerned with keeping the knee you already have. Where the cartilage surface is still largely intact, damage to a meniscus, a ligament or the alignment of the limb can often be treated directly, without resurfacing the joint. The aim is to restore the mechanics of the knee rather than replace them.

That matters most in younger and active patients. A knee replacement has a finite lifespan, and one performed at forty is far more likely to need revising than one performed at seventy. Every year a native knee can be kept working is a year that decision is deferred.

When preservation is the right approach

Preservation is considered when the joint surface is largely intact, the problem is structural, and the symptoms match the finding. A meniscus torn in a twisting injury, a knee left unstable after a ligament rupture, a kneecap that dislocates, or a limb whose alignment is overloading one side of the joint are all problems where the knee itself can usually be kept.

It is not the right approach for everyone. Where the cartilage is already worn through and the X-ray shows bone against bone, repairing a meniscus will not relieve the pain, because the meniscus is not the source of it. In that situation a partial or total knee replacement gives a far more reliable result, and saying so early saves a patient an operation that was never going to work.

The distinction runs both ways. Some patients are offered an arthroscopy for a degenerative tear that would do better with physiotherapy and time. Others are told nothing can be done short of a replacement when a repairable tear is sitting on the MRI. Both are avoidable, and both come down to reading the whole picture rather than the scan alone.

The operations

Knee preservation is not one procedure. It is a group of operations chosen to match what has actually failed in the knee.

How the decision is made

The assessment starts with the history, because the symptoms often tell you more than the scan does. A knee that catches and locks is behaving mechanically. A knee that aches after activity and is stiff first thing in the morning is behaving degeneratively. The MRI then defines what is torn, and weight-bearing X-rays show whether joint space has been lost and how the limb is aligned.

Dr Mooney sees every patient himself, reviews the imaging before the day of surgery, and performs every operation personally. Where surgery is not the right answer, that is said plainly and the alternative is set out.