The knee joint comprises the ends of the femur (thigh bone) and tibia (shin bone). The meniscus is a rubbery, C-shaped disc that cushions your knee. It also helps to protect the cartilage in the knee. Each knee has two menisci - one at the outer edge of the knee and one at the inner edge. The menisci function as shock absorbers in the knee and help maintain stability within the knee. Injuries to the meniscus can occur after acute traumatic injuries or chronic repetitive injuries. Meniscus injuries can result in pain, swelling and stiffness of the joint.
A meniscus injury within the knee is diagnosed after a thorough clinical assessment of the knee. MRI scans are conducted to confirm the diagnosis and look for concomitant knee injuries, such as ligament tears and cartilage injuries. Patients with small meniscus tears may be treated non-surgically with a course of rehabilitation. However, patients with large or displaced meniscal tears who develop persistent pain, swelling and loss of joint function are candidates for surgical treatment. Surgical treatment involves minimally invasive knee arthroscopy (or keyhole surgery) and includes the following options:
At the same time, concomitant ligament and cartilage injuries may need to be addressed. Such surgery is usually performed under general anaesthesia and takes about 1-2 hours. An overnight stay in the hospital is usually required after the surgery, and 4-6 weeks of crutch-assisted ambulation may be advised.
A physiotherapist generally supervises the rehabilitation process after the surgery, which consists of progressive knee range of motion exercises, muscle strengthening exercises, and sport-specific drills. The whole rehabilitation process may last 4-6 months following the procedure. The success rate of meniscus surgery has been reported to be about 80-90%. The complications of this procedure include infection, meniscus retears, and future osteoarthritis (if meniscectomy is performed).
ACL is an acronym for the ‘anterior cruciate ligament’. It is an important ligament found in the centre of the knee, and it helps maintain knee stability by preventing forward and twisting movements of the tibia (or shin bone) relative to the femur (or thigh bone). Injuries to the ACL are common. They usually occur due to twisting, non-contact injuries during sports such as soccer, basketball, or netball.
The risk factors for ACL injuries include female gender and familial predisposition. The diagnosis of an ACL injury is made after a thorough clinical assessment of the knee. MRI scans confirm the diagnosis and look for concomitant knee injuries, such as meniscal tears and cartilage injuries.
Some patients with isolated tears of the ACL may be treated non-surgically with a course of rehabilitation. However, patients with symptoms of recurrent knee instability, concomitant repairable meniscal tears, and individuals keen to return to competitive pivoting sports (such as soccer, basketball or netball) are candidates for surgical treatment.
Surgical treatment involves ACL reconstruction. This surgery is usually performed under general anaesthesia, using minimally invasive arthroscopic (keyhole) techniques. The surgery involves replacing the torn ACL with a new ACL graft. Bone tunnels are drilled in the femur and tibia within the knee, and a new ACL graft is secured within these tunnels. This new graft may be obtained from the patient himself (autograft) or a donor (allograft). At the same time, concomitant injuries to the menisci or cartilage may be repaired. An overnight stay in the hospital is usually required after ACL reconstruction, and 2-4 weeks of crutch-assisted ambulation may be advised.
A physiotherapist supervises the rehabilitation process after the surgery, which consists of progressive knee range of motion exercises, muscle strengthening exercises, and sport-specific drills. The rehabilitation process may last 9-12 months following the ACL reconstruction. The success rate of ACL reconstruction surgery has been reported to be about 90%. The complications of this procedure include ACL graft injury, knee stiffness and infection.
An anterior cruciate ligament (or ACL) reconstruction is safe and effective. However, the ACL graft may tear or fail in about 5-10% of cases. Higher rates of graft tears of up to 30% have been reported in young patients involved in competitive sports. The risk factors for graft failure include reinjury, technical issues arising from the initial surgery, and associated injuries that compromise knee stability.
A torn or failed ACL graft is diagnosed after a thorough clinical assessment of the knee. MRI scans are done to confirm the diagnosis and to look for concomitant knee injuries. CT scans may also be needed to assess the positions of the bone tunnels used in the previous ACL reconstruction and to look for possible excessive enlargement of these tunnels.
In patients with knee instability symptoms due to a torn or failed ACL graft, revision surgery is needed to improve knee stability. The surgery involves drilling new bone tunnels in the knee and securing a new ACL graft within these tunnels. This new graft may be obtained from the patient (autograft) or a donor (allograft). At the same time, an extra-articular lateral tenodesis may be added to enhance the knee's stability. This involves using part of the iliotibial band to secure and improve the rotational stability of the knee. An overnight stay in the hospital is usually required after revision ACL reconstruction, and 2-4 weeks of crutch-assisted ambulation may be advised.
Revision ACL reconstruction is a technically demanding procedure and should be carried out by trained and experienced surgeons. It is often carried out in one stage, although the surgery may need to be divided into two stages in a few patients. In the first stage, bone grafting of the old tunnels is done, especially if there is significant widening of these tunnels, as they may compromise graft fixation. The second stage of the procedure is carried out several months later, once the bone grafts have healed and completely filled up the widened spaces within the old tunnels. In the second stage, new bone tunnels are created, and a new ACL graft is secured within these tunnels.
After revision ACL reconstruction, the rehabilitation process is often slower and longer than the following primary ACL reconstruction. It may last up to 12-18 months following the revision procedure. The success rate of revision ACL reconstruction has been reported to be approximately 75%. The complications of this procedure include infection, knee stiffness and recurrent graft failure.
PCL is an acronym for the ‘posterior cruciate ligament’. It is an important ligament found in the centre of the knee, and it helps maintain knee stability by preventing backward movements of the tibia (or shin bone) relative to the femur (or thigh bone). Injuries to the PCL are less common than those to the ACL (or anterior cruciate ligament). They usually occur due to direct contact injuries to the knee during road traffic accidents or sporting activities.
The diagnosis of a PCL injury is made after a thorough clinical assessment of the knee. MRI scans confirm the diagnosis and look for concomitant knee injuries, such as other knee ligament tears, meniscal tears and cartilage injuries. Most patients with isolated tears of the PCL may be treated non-surgically with a course of rehabilitation. However, patients with severe tears, those with symptoms of recurrent knee instability and those with additional ligament and meniscal tears are candidates for surgical treatment.
Surgical treatment involves PCL reconstruction. This surgery is usually performed under general anaesthesia, using minimally invasive arthroscopic (keyhole) techniques. The surgery involves replacing the torn PCL with a new PCL graft. Bone tunnels are drilled in the femur and tibia within the knee, and a new PCL graft is secured within these tunnels. This new graft may be obtained from the patient (autograft) or a donor (allograft). At the same time, concomitant injuries to the other ligaments, menisci or cartilage may be addressed. An overnight stay in the hospital is usually required after PCL reconstruction, and 4-6 weeks of crutch-assisted ambulation may be advised.
A physiotherapist supervises the rehabilitation process after the surgery, which consists of progressive knee range of motion exercises, muscle strengthening exercises, and sport-specific drills. The rehabilitation process may last 9-12 months following the PCL reconstruction procedure. The success rate of PCL reconstruction surgery has been reported to be about 80-90%. The complications of this procedure include PCL graft injury, knee stiffness and infection.
Multi-ligament knee injuries are severe orthopaedic conditions that involve damage to two or more of the major ligaments in the knee joint, such as the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), or lateral collateral ligament (LCL). These injuries often occur due to high-energy trauma, such as sports injuries or motor vehicle accidents, and can result in significant instability and functional impairment of the knee.
At Orthopaedic and Hand Surgery Partners, we offer expert care for multi-ligament knee injuries and provide comprehensive evaluation, diagnosis, and treatment options. Multi-ligament reconstruction surgery is a complex procedure for restoring stability and function to the knee by reconstructing the damaged ligaments using graft tissue that is either taken from the patient (autograft) or donor (allograft).
During the surgery, our orthopaedic surgeon meticulously assesses the extent of ligament damage and reconstructs each affected ligament using advanced surgical techniques and specialised equipment. We also pay attention to postoperative rehabilitation, such as recommending strengthening exercises and a gradual return to normal activity, which remains crucial for a complete and smooth recovery process. Through personalised treatment plans and compassionate care, we help our patients recover from multi-ligament knee injuries and enable them to return to an active lifestyle with improved knee stability and reduced risk of long-term complications.
Joints are formed when the ends of two bones meet. For example, the knee joint comprises the ends of the femur (thigh bone) and tibia (shin bone). Cartilage is the smooth elastic tissue that covers the ends of the bones at these joints. The cartilage allows the joint surfaces to glide smoothly and painlessly against each other. Injuries to the cartilage can occur with acute traumatic injuries or with chronic repetitive injuries. Cartilage injuries can result in pain, swelling and stiffness of the joint. A cartilage injury within the knee is diagnosed after a thorough clinical assessment of the knee. MRI scans confirm the diagnosis and look for concomitant knee injuries, such as meniscal tears and ligament injuries.
Patients with small cartilage injuries may be treated non-surgically with a rehabilitation course. However, patients with cartilage injuries who develop persistent pain, swelling, and loss of joint function are candidates for surgical treatment. Surgical treatment involves cartilage repair. Cartilage has a low potential for intrinsic repair because of its poor blood supply. Therefore, specialised repair techniques are employed to repair this tissue. These include:
At the same time, bone reshaping or osteotomy may also be performed to correct significant abnormalities in joint alignment that may affect the cartilage healing process. Such surgery is usually performed under general anaesthesia, using minimally invasive arthroscopic (keyhole) techniques. An overnight stay in the hospital is usually required after the surgery, and 4-6 weeks of crutch-assisted ambulation may be advised. The use of a continuous passive motion machine may also be beneficial.
A physiotherapist generally supervises the rehabilitation process after the surgery, which consists of progressive knee range of motion exercises, muscle strengthening exercises, and sport-specific drills. The whole rehabilitation process may last 6-9 months following the procedure. The success rate of cartilage repair surgery has been reported to be about 70-90%. The complications of this procedure include knee stiffness, infection and cartilage reinjury.
Patellar (or kneecap) dislocations are common injuries and affect mainly adolescents and young adults. In this condition, the patella moves out of its usual location in the front of the knee to the lateral or outer side of the knee. This can occur because of direct trauma or a twisting injury of the knee.
The risk factors for patella dislocations include generalised ligamentous laxity, a valgus (or knock-knee) deformity of the knee and a shallow trochlea (groove for the patella) in the front of the knee. A patella dislocation is diagnosed after a thorough clinical assessment of the knee. MRI scans confirm the diagnosis and look for concomitant knee injuries and anatomical risk factors.
First-time acute patella dislocations are usually treated with a period of knee immobilisation. Surgery is usually not required unless there is a significant cartilage injury that needs to be addressed. In patients with recurrent patella dislocations and symptoms of patella instability, reconstructive surgery is required to improve patella stability. The most common surgical procedure is medial patellofemoral ligament (MPFL) reconstruction. The surgery involves drilling two bone tunnels in the inner or medial side of the patella and another bone tunnel in the medial or inner side of the knee. A hamstring tendon graft is then passed through and secured within these tunnels to serve as a check-rein to prevent further lateral or outward dislocation of the patella.
Sometimes, additional concomitant procedures may need to be carried out to ensure patella stability. These include tibial tubercle (shin bone) transfers and trochlea (thigh-bone groove) reshaping. An overnight stay in the hospital is usually required after such reconstructive surgery, and 1-2 weeks of crutch-assisted ambulation may be advised.
The rehabilitation process after the surgery consists of progressive knee range of motion, muscle strengthening exercises, and functional recovery. It may last up to 6-9 months following the procedure. The success rate of patella instability surgery has been reported to be about 80-90%. The complications of this procedure include infection, knee stiffness and recurrent patella instability.
The knee joint is formed by the lower end of the femur (thigh bone) and the upper end of the tibia (shin bone). The joint surfaces are covered by a smooth elastic tissue called cartilage. The cartilage allows the joint surfaces to glide smoothly and painlessly against each other. Damage to the cartilage and bone within the knee joint is called osteoarthritis. This can result from degeneration (wear and tear) or trauma (fractures and ligament injuries).
Patients who develop osteoarthritis of the knee joint can present with pain, stiffness, joint deformity and limping. This can sometimes be severe enough to affect daily mobility and quality of life. Knee osteoarthritis is diagnosed after a thorough clinical assessment of the knee joint. X-rays and MRI scans are done to confirm the diagnosis.
Patients with early osteoarthritis and mild symptoms may be treated non-surgically with a course of rehabilitation. However, patients with severe symptoms and advanced osteoarthritis are candidates for surgical treatment. In particular, patients who are relatively young and physically active may benefit from joint preservation surgery in the form of knee osteotomy.
Knee osteotomy (or bone-reshaping surgery) is used to improve the overall alignment and shape of the knee. This is useful in patients with osteoarthritis, mainly affecting one compartment of the knee associated with deformity or bowing of the knee. (See Figures below) Such surgery is usually performed under general anaesthesia and may take about 2 hours. A 1-2 stay in the hospital is generally required after the surgery, and 4-6 weeks of crutch-assisted ambulation may be advised.
A physiotherapist generally supervises the rehabilitation process after the surgery, which consists of progressive range of motion exercises, muscle strengthening exercises, and functional therapy. The whole rehabilitation process may last 3-6 months following the procedure. The success rate of knee osteotomy surgery has been reported to be about 80-90%. The complications of this procedure include infection, damage to the blood vessels and nerves around the knee, and progression of osteoarthritis in the knee.
The knee joint is formed by the lower end of the femur (thigh bone) and the upper end of the tibia (shin bone). The joint surfaces are covered by a smooth elastic tissue called cartilage. The cartilage allows the joint surfaces to glide smoothly and painlessly against each other. Damage to the cartilage and bone within the knee joint is called osteoarthritis. This can result from degeneration (wear and tear), trauma (fractures and ligament injuries), avascular necrosis (depletion of the blood supply to the bone) and inflammatory disorders (such as rheumatoid arthritis).
Patients who develop osteoarthritis of the knee joint can present with pain, stiffness, joint deformity and limping. This can sometimes be severe enough to affect daily mobility and quality of life. Knee osteoarthritis is diagnosed after a thorough clinical assessment of the knee joint. X-rays and MRI scans are done to confirm the diagnosis. Occasionally, additional blood tests may be done to identify the underlying cause of the osteoarthritis.
Patients with early osteoarthritis and mild symptoms may be treated non-surgically with a course of rehabilitation. However, patients with severe symptoms and advanced osteoarthritis may be candidates for surgical treatment in the form of knee replacement surgery.
Knee replacement surgery involves replacing the worn-out surfaces of the knee joint with prosthetic devices, which are made of cobalt-chromium, titanium and polyethylene (medical-grade plastic). If only one knee compartment is involved, partial or unicompartmental knee replacement may be performed. In this procedure, only the affected part of the knee surface is replaced by prosthetic components. If more than one compartment of the knee is affected by osteoarthritis, then total knee replacement is carried out. In this case, all the surfaces of the knee are replaced by prosthetic components. Such surgery is usually performed under general anaesthesia and may take about 2 hours. A 3-4 stay in the hospital is generally required after the surgery, and 2-6 weeks of walking aid-assisted ambulation may be advised.
A physiotherapist generally supervises the rehabilitation process after the surgery, which consists of progressive range of motion exercises, muscle strengthening exercises, and functional therapy. The whole rehabilitation process may last 3-6 months following the procedure. The success rate of knee replacement surgery has been reported to be 90%. The complications of this procedure include deep vein thrombosis, infection and prosthetic wear.
Knee replacement surgery is generally a safe and effective procedure. However, knee replacement may loosen, wear out, or develop instability in some patients. Patients who develop such complications may experience pain, stiffness and difficulty walking.
A malfunctioning knee replacement is diagnosed after a thorough clinical assessment of the knee joint. X-rays, CT scans, and specialised MRI scans may also be needed to confirm the diagnosis and look for associated problems such as bone loss around the knee replacement.
In patients with malfunctioning knee replacement, revision surgery may be necessary to reduce pain and restore mobility. The surgery involves replacing one or more components of the knee replacement, which have failed. At the same time, areas of bone loss may need to be restored with a bone graft from the patient (autograft) or a donor (allograft) or replaced with metal blocks.
Revision knee replacement is a technically demanding procedure and should be carried out by trained and experienced surgeons. Such surgery is usually performed under general anaesthesia and may take 2-3 hours. A 3-4 stay in the hospital is generally required after the surgery, and 2-6 weeks of walking aid-assisted ambulation may be advised.
The rehabilitation process after revision knee replacement is often slower and longer than the following primary knee replacement. It may last up to 6-12 months following the revision procedure. The success rate of revision knee replacement has been reported to be approximately 80%. The complications of this procedure include deep vein thrombosis, infection and loosening of the new prosthesis.
Driven by compassion, decades of experience in orthopaedic care, and modern technology, we strive to provide patient-centric care by alleviating pain, restoring mobility, and improving the quality of life for all our patients. At Orthopaedic and Hand Surgery Partners, where compassion meets experience, you can trust in us.
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6A Napier Road #03-37
Gleneagles Annexe Block
Singapore 258500
Monday to Friday: 0900 - 1730hrs
Saturday: 0900 - 1230hrs
Closed on Sunday & Public Holidays
820 Thomson Road #06-08
Mount Alvernia Medical Centre A
Singapore 574623
Monday to Friday: 0900 - 1730hrs
Closed on Saturday, Sunday & Public Holidays
