Battle of Wounded Knee

More than two million working days are lost each year in the UK due to knee injuries – but new treatments being pioneered locally aim to cut the number

Knobbly, hairy, or waxed and smooth as silk. Knees come in all shapes, sizes and ‘finishes’. But whichever best describes yours, knees all have one thing in common. They’re the largest and most complicated joint in the human body and, with the possible exception of our hands, they have the toughest job.

When you walk, your knee bears a force that’s up to five times your body weight with every step. So, even if you’re a featherweight 120lbs, that’s a force of getting on for 600lbs. No wonder our knees get sore and damaged so easily. To prove the point, 2.4 million work days are lost in the UK every year because of lower limb disorders (HSE) and damage to the knee is among the most common injuries, especially in those playing sports.


“We see a lot of knee injuries in sport but more serious joint injuries can be overlooked and treated as ligament sprains,” said Ashvin Pimpalnerkar, consultant orthopaedic surgeon at Spire Hospital Little Aston. He has a wealth of experience treating sports injuries both in the UK and abroad, working as club surgeon at Birmingham and Walsall Football Clubs and with the Calgary Flames ice hockey team in Canada.

“The knee joint is particularly vulnerable to damage and pain because it takes the full weight of your body and any extra force when you run or jump,” he explained. “You’re more likely to experience knee pain as you get older, and people who are overweight or do lots of sports have a higher risk of damaging their knees. Some sports that involve a lot of turning, such as football, netball and skiing, carry a particularly high risk of injury. My advice with knee injuries is always to get them accurately diagnosed and treated as soon as possible because any delay can cause serious changes to the joint.”

The good news is that a host of new techniques are being used by specialists to improve knee injury treatment and rehabilitation. We asked Mr Pimpalnerkar about some of the latest developments in knee surgery and how patients with knee pain can expect to make a faster recovery than ever before.


Surgery of the knee and ligaments now uses advanced robotic devices combined with complex imaging technology to allow procedures to be carried out through small incisions. This can result in less pain, blood loss and faster recovery for patients. “Computer-assisted surgery is a technique that uses 3D imaging and real-time monitoring in surgery,” said Mr Pimpalnerkar. “This has distinct advantages over conventional techniques and allows for better visualisation and improves the accuracy and precision of the surgical procedures.”

Cartilage injuries cause pain, swelling and reduced movement of the knee and are the result of general wear and tear or through a specific injury. The latest techniques to treat these injuries involve harvesting cartilage cells through keyhole surgery and culturing and multiplying them in the laboratory. They are then re-injected into the knee at a later stage.

“We are now able to preserve the life of the knee joint in some patients using techniques such as a cartilage transplant. This enables the patient to extend the life of their knee, minimise future damage and continue their active lifestyle for longer,” said Mr Pimpalnerkar.


There are four major bones in the knee – the femur, tibia, fibula and patella – and three joints.

The knee has 14 ligaments – seven intracapsular ligaments, including the anterior cruciate (ACL) and posterior cruciate (PCL), and seven extracapsular ligaments, including the medial collateral (MCL) and the lateral collateral (LCL).

More than 100,000 people a year undergo knee surgery in the UK alone

97% of knee replacements are carried out due to arthritis.

Mr Ashvin Pimpalnerkar is consultant orthopaedic surgeon at Spire Hospital Little Aston, Sutton Coldfield, B74 3UP. Tel: 0121 580 7119