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Leg Pain- ankle, knee, hip and back - all connected

Hip, Knee or Back?

Surgical precision – not only the precision of work when you are performing surgery, but precision in making the choice of where and how to operate.

 Taking the time

A 5 minute consultation is not enough. An MRI scan alone is not enough.

Let’s say you come to me complaining of pain in your right knee.

Now the simple thing for me to do is to listen to your brief history, send you for an MRI scan of your right knee and then, because if you are over 35 years old you probably have some arthritic changes to the knee, pronounce that you need surgery.

What I actually need to do is listen to your history, ask more questions to get details and then, this may shock you, get you to take your trousers off!

I need to look at your knee in the flesh and see it move while you walk up and down while I watch.

I need to examine your ankle and hip on your right side, examine your lower back AND the left knee.

Making a connection

What’s the purpose of this is? Surgical precision.

I don’t want to operate on your right knee, only to realise, 6 months later when you aren’t making good progress, that actually the reason your right knee hurt is because you damaged your left knee a decade ago and your right knee has been compensating ever since.

Or that actually the knee pain was referred from the right hip. Or your right ankle. Or your lower back.

I only want to operate once. I want to get it right.'David discards his measuring tape for the faster 'eyeballing' method of measuring.'

Making the right choice

We also need to decide whether surgery is the right option for you and if it is, which procedure.

Perhaps we need to use some pain relief to get you out of the acute phase right now but monitor the situation for the future.

There are several joint preservation techniques which can be more helpful than simply replacing the uncomfortable joint.

A carpenter friend once taught me the phrase, “Measure twice, cut once.” As apt for surgery as carpentry.

 

 

 

 

Dr Jyri Lepisto, Orthopaedic ConsultantDr Jyri Lepisto

Orthopaedic Consultant

Colegio No. 29/29/11425

MD, PhD, eMBA

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