What is the most common performed joint arthroplasty operation? It’s the Total Knee Replacement (TKR) that is required by people ranging in ages from young sports players to the elderly that have worn their knees out.

Data from the Medicare database estimates there were 55,000 TKRs in 2015 and the number is increasing each year.

There’s diversity in the market but most TKRs last more than than 10 years.

Most implants are made from medical grade chrome cobalt steel and ultra high molecular weight polyethylene. Some companies are now using a hardened version of the plastic and others use titanium parts or ceramicised coatings, but none of these variations appear to improve long-term results.

Designs can be broadly categorised into fixed or mobile bearing implants. The first act like hinges and the latter give some degree of rotation to the implants - outcomes are broadly the same.

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Associate Professor in Orthopaedics at the Graduate School of Medicine, University of Wollongong and formerly NSW University, John Ireland of Seaview Clinic in Wollongong has more than 20 years of clinical expertise and specialist experience with hip, knee and shoulder surgery.

His current experience includes almost 4000 joint replacements using all validated types of prostheses and minimal invasive techniques. He said most patients are still far better off as a result of the surgery, despite concerns.

The surgeon utilises the latest computer navigation techniques too. “This technology improves accuracy which is particularly beneficial in younger more active patients,” he said.

Sydney born and trained, Dr John Ireland was head of the Orthopaedic Department at Liverpool Public Hospital and Chairman of the Whitlam Joint Replacement Centre.

Hips are the second most replaced joint, and most often for osteoarthritis. The numbers are increasing at 2 per cent per annum as is durability of 90 per cent at 15 years – National Joint Replacement Registry.

This is largely down to improved bearing surfaces of ceramic and hard plastics, both of which show minimal wear at 15 years.

Now less invasive surgery is by operating between tissue planes, rather than by detaching muscles. These techniques report less pain, quicker mobilisation, lower incidence of dislocation and less need for a blood transfusion.

An increasing number of people are returning to work by six weeks and returning for review at 12 months with no symptoms, a normal range of motion and gait.

“The patient benefits for an anterior approach hip replacement include an earlier return to activities and work,” Assoc. Prof. Ireland said.

Seaview Clinic, Suite 701, Wollongong Private Hospital, 360-364 Crown St. Phone 9821 2599 or go to seaviewclinic.com.au