As a dedicated – knee only – orthopaedic surgeon, and member of the Australian Knee Society (AKS), Dr Gallagher performs a high volume of knee procedures which are considered as; Rejuvenative, Reconstructive or Replacement type procedures. The following list is not an exhaustive one but includes the twenty most common operations performed by Dr Gallagher at Queensland Knee Surgery Clinic (QKSC).
Rejuvenative procedures include those where existing tissue is restored to a more normal state, such as where a torn meniscal cartilage is trimmed (arthroscopy) and / or sutured back into place (meniscal repair) arthroscopically, or where loose damaged patella cartilage is tidied up and tight lateral retinacular bands tilting the patella excessively are released arthroscopically (lateral release), or where missing tissue such as articular cartilage lining the bones is replaced (cartilage transplant) or substituted (microfracture) or meniscal cartilage between the bones is replaced (meniscal transplant).Read More
Reconstructive procedures include those where ligamentous structures (ACL, PCL, LCL, MCL, PCL, PLC) are repaired or rebuilt using the patient’s own tissue and various reconstructive devices (RCI screws, bone staples, fixation posts, endobuttons). Occasionally patients require more than 3 ligaments (multiligament reconstruction) to be reconstructed at once, or previously reconstructed ligaments that have subsequently failed to be reconstructed again (revision ligament reconstruction) and depending on patients circumstances and their own tissue availability, occasionally donor tissue (allograft) or a synthetic ligament (LARS) may be considered for use. If the knee problems are being contributed to by a malalignment, the reconstructive techniques may include realignment using a combination of soft tissue releases and advances (patellofemoral realignment) or bony cuts or osteotomies to the tibia (HTO), femur (DFO) or tibial tuberosity (TTO) with internal fixation using metallic devices (screws, plates) and where necessary, bone grafting. These are generally larger operations, designed to alleviate instability, pain, swelling and to restore confidence with the knee, for both day to day activities and higher demand physical duties, including manual physical labour and sporting activities. Finally, for those patients with unicompartmental (most often medial compartment) arthritis and a deficient ACL, as an alternative to a total knee replacement (TKR), a combined ACL reconstruction and HTO can be considered as a joint preserving or “salvage” procedure.Read More
The knee joint endures more load across it than any other joint in the human body and can develop wear and tear loss of cartilage commonly referred to as osteoarthritis which is the most common form of arthritis, affecting nearly 2 million Australians. Depending on the severity of the arthritis and the patient’s symptoms, it may appropriate to consider replacing the knee with a prosthetic device or knee replacement. If a knee replacement resurfaces both the inside (medial compartment) and the outside (lateral compartment) parts of the knee with or without resurfacing the patella (patellofemoral compartment), it is considered a total knee replacement (TKR). If just one compartment is replaced, it is known as a unicompartmental knee replacement (UKR). If patients have significant bone loss (severe arthritis, previous trauma or surgery) or pronounced deformity with poorly functioning ligaments, a more complex knee replacement prosthesis (complex primary TKR) may be required. Similarly, when an existing knee replacement fails and needs revision, the revision replacement (revision TKR) often will require metallic augments and long stems to allow for stable fixation and correct alignment and possibly a more constrained plastic liner or hinged articulation to provide a stable knee joint. If a knee replacement is being revised for infection, it will usually be done in at least two stages with one operation for removal of the knee replacement and infected tissue and implantation of a temporary knee replacement spacer impregnated with antibiotics, and another operation to re-replace the knee replacement, after a period of antibiotic therapy and eradication of the infection.Read More