In some people with arthritis of the knee that are considering further surgery, it is possible to keep their knee joint by realigning the leg so that the bad part of the knee is offloaded. This involves surgically breaking the tibia or the femur bone. Although this sounds very drastic, if successful, it can delay the need for a knee replacement for many years, and allows unlimited activity (unlike a TKR). Hence it is particularly useful for younger, patients, especially if they wish to return to significant sport or high activity.
For this operation to be successful, the knee needs to have nearly normal range of movement, and have arthritis limited to one side of the knee only. I assess suitability for this with an examination and an arthroscopy of the knee. The surgical fracture (osteotomy) is usually carried out on the inner aspect of the tibia (shin bone) and is then known as a high tibial osteotomy.
(Fig 1) If done on the femur, the osteotomy is usually carried out on the outer aspect of the femur bone and is known as a distal femoral osteotomy.
(Fig 2) The bone is fixed with a plate. The patient is mobilized straight away and usually goes home on the second day, on crutches. It takes at least 3 months before these patients can get back to full activity. Complications are surprisingly rare but include infection, DVT/PE, nerve injury, non-healing osteotomy.
Overall, the average osteotomy lasts more than 7 years before further surgery is required (other than removal of the plate).
Fig 1. X-Ray of a high tibial osteotomy.
Fig. 2. X-Ray of a distal femoral osteotomy
How to make an appointment?
Please contact my secretary Silvana on 0428 585 601 or (08) 9312 1135
Fax: (08) 6161 1664
Email: silvana@orthopaedicswa.com.au
Do I need a Doctor’s referral to see Mr. Gohil?
Yes, a written referral from a registered practitioner in Australia is required.
A referral from a GP lasts 12 months, and a referral from another specialist lasts 3 months.
The backdating of referrals is illegal.
Where else does Mr. Gohil work and operate?
Mount Hospital
Fremantle Hospital
Fiona Stanley Hospital
Mr. Satyen Gohil is a no gap provider for all health funds (provided your health fund covers the procedure), meaning that for the surgery, there no extra costs charged to the patient for the surgery or anaesthetic above that which is covered by the health funds.
Initial consultation cost is $200 Follow up appointments are $100 There are no further costs for post-operative visits for the first 6 weeks, after which time the cost of each visit is $100. Workers compensation and MVIT consultation fees will be sent direct to the insurer. However, if the claim number is not provided you will be responsible for settling the account on the day.
Blood tests
There is an out of pocket charge for blood tests.
Anaesthetist
Your anaesthetist will be Dr. Harper, Dr.Crossley, Dr. White or Dr. Thompson, who will contact you by telephone before the day of surgery to explain about the anaesthetic. They will see you on the day of surgery in the hospital.
Radiology
X-rays as an inpatient are covered, but outpatient X-rays and CTs within the hospital have an out of pocket cost.
MRI costs vary considerably depending on where they are done. Please ask for more details.
www.skg.com.au
Cardiology
For ECG (heart tracings) I use WA cardiology as appointments are not needed. There is a charge above the Medicare rebate.
www.wacardiology.com.au
Medical reports and insurance forms
Are charged at a rate representing the time taken to complete the forms.
Full payment at the appointment time is appreciated. Cash or credit cards are acceptable means of payment. For bank and personal cheque please make prior arrangements with the reception.
Useful links
Medicare Australia
http://www.medicareaustralia.gov.au/
St John of God Murdoch Hospital
http://www.sjog.org.au/hospitals/murdoch.aspx
Department of Veteran Affairs
http://www.dva.gov.au/Pages/home.aspx
Please get in touch with us by completing the form here or alternatively you can contact us by fax or phone at the numbers below. We will endeavour to get back to you as soon as possible.