In FY2021-22, there were more than 53000 total knee replacements performed in Australia


Over 10% of people over the age of 60 have symptomatic knee OA

Knee arthritis, also known as osteoarthritis of the knee, is a degenerative joint condition characterized by the gradual breakdown of the protective cartilage in the knee joint. The causes of knee arthritis are multifactorial and include aging, genetic predisposition, joint overuse, previous knee injuries, and obesity. The natural history of knee arthritis involves the progressive deterioration of the joint, leading to pain, swelling, and reduced mobility. Symptoms typically include pain, stiffness, and a grating or grinding sensation during movement. As the condition advances, activities such as walking, climbing stairs, and even routine daily tasks can become challenging.

Treatment for knee arthritis aims to alleviate symptoms and improve joint function. Conservative measures include weight management, physical therapy, pain medications, and the use of assistive devices. In more advanced cases, surgical interventions such as knee joint replacement may be considered to replace the damaged joint surfaces and provide long-term relief. Early diagnosis and a comprehensive treatment approach are essential for managing knee arthritis effectively and improving the quality of life for individuals affected by this condition.

Around 2.1 million Australians (1 in 11 people) have OA, with a 58% increase expected by 2032 due to population ageing and rising obesity rates

A total knee replacement, or total knee arthroplasty, is a surgical procedure that involves replacing the damaged or diseased surfaces of the knee joint with artificial components. The surgery is typically performed to address severe arthritis or joint damage that causes persistent pain and limits mobility. During the procedure, the orthopedic surgeon removes the damaged cartilage and bone from the ends of the femur (thigh bone) and tibia (shin bone) and replaces them with metal implants. A plastic spacer is inserted between the metal components to allow for smooth joint movement. Additionally, the undersurface of the kneecap may also be resurfaced with a plastic component. The artificial components replicate the function of a healthy knee, providing pain relief and restoring joint stability. Total knee replacement is a highly successful procedure that can significantly improve the quality of life for individuals suffering from debilitating knee conditions.

Depending on the type of arthritis you have and the degree of severity, it may be appropriate to undergo a partial knee replacement instead of a total knee replacement, in which only one compartment of the knee is replaced. Partial knee replacements have a faster recovery time and result in a more natural feeling knee. During your consultation, Jason will evaluate your knee to determine if a partial knee replacement is appropriate for you.


Dr Jason Hockings utilises a subvastus approach for his total knee replacements. The medial subvastus approach for total knee replacement offers several benefits over the traditional medial parapatellar approach. In the subvastus technique, the surgeon makes a smaller incision on the inner side of the knee, avoiding the disruption of the quadriceps muscle and the patella tendon. This muscle-sparing approach aims to preserve the natural anatomy, leading to reduced postoperative pain, faster recovery, and improved early mobility. Patients undergoing a medial subvastus approach often experience less blood loss, reduced risk of postoperative stiffness, and a shorter hospital stay compared to the medial parapatellar approach. The incision also contributes to better cosmetic outcomes with minimal scarring. While both approaches can be effective, the medial subvastus approach is gaining popularity for its potential advantages in terms of quicker rehabilitation and overall patient satisfaction in total knee replacement surgery.


Dr Jason Hockings uses robotic assistance to perform his knee replacements in order to achieve the best possible outcomes using the most advanced technology available. While total knee replacement has excellent outcomes, studies suggest that up to 5-10% of patients remain dissatisfied with their knee replacement after their surgery. Robotic assisted knee replacement aims to reduce this number as well as improving the longevity and kinematics of the knee replacement.

Robotic-assisted total knee replacement (TKR) offers several potential benefits over traditional methods, enhancing precision and patient outcomes. Some key advantages include:

Enhanced Precision: Robotic systems provide three-dimensional imaging, allowing for precise preoperative planning. During surgery, the robot assists the surgeon in executing the planned procedure with high accuracy, resulting in optimal alignment and component placement.

Personalized Planning: Robotic-assisted TKR enables a more personalized and tailored approach. The technology allows surgeons to create a detailed, patient-specific plan based on the individual’s anatomy and specific knee characteristics, enhancing the overall fit and function of the implant.

Improved Implant Positioning: The robotic system aids in achieving optimal alignment and positioning of the knee implant. Proper alignment is crucial for long-term implant durability and function, potentially reducing the risk of premature wear and loosening.

Tissue Preservation: The precision offered by robotic assistance allows for more minimal tissue disruption during surgery. This may result in less trauma to surrounding structures, potentially leading to a faster recovery, reduced pain, and improved overall patient satisfaction.

Real-Time Adjustments: Robotic systems provide real-time data during the surgery, allowing the surgeon to make intraoperative adjustments for optimal implant positioning. This adaptability enhances the surgeon’s ability to achieve the desired outcome.

Reduced Blood Loss: The precision of robotic-assisted surgery may contribute to reduced blood loss during the procedure, potentially leading to a lower likelihood of transfusions and postoperative complications.


The recovery following a total knee replacement (TKR) is a gradual process that involves different stages, and individual experiences can vary. Here is a general overview of the recovery timeline:

Immediate Postoperative Period (Days 1-3)

Patients typically stay in the hospital for a few days.

Physical therapy starts soon after surgery, focusing on mobility, muscle activation, and walking with assistive devices.

Weeks 1-6

Patients continue with physical therapy to improve joint flexibility, strength, and walking abilities.

Pain management remains a priority during this phase.

Gradual reduction in the use of assistive devices (cane or walker).

Weeks 6-12

Continued physical therapy focuses on increasing strength and range of motion.

Patients work on activities of daily living and more functional movements.

Return to normal activities with caution.

Months 3-6

Progressive improvement in strength and endurance.

Transition to more demanding exercises and activities.

Follow-up appointments with the surgeon to monitor progress.

Months 6 and Beyond

Many patients experience significant improvement in joint function and reduced pain.

Continued participation in physical therapy or home exercise programs.

Gradual return to more strenuous activities, depending on the individual’s progress and surgeon’s recommendations.

It’s important to note that while most patients achieve substantial pain relief and improved function after a TKR, complete recovery can take several months, and individual outcomes vary. Adhering to the prescribed rehabilitation plan, maintaining a healthy lifestyle, and following the guidance of the healthcare team are crucial for optimizing recovery and achieving the best long-term results.


Anterior cruciate ligament (ACL) reconstruction is a surgical procedure commonly performed to address a torn or ruptured ACL, a key stabilizing ligament in the knee joint. The leading cause of ACL injuries is often sports-related trauma, involving sudden stops, changes in direction, or direct blows to the knee. The natural history of an untreated ACL tear can lead to instability, ongoing joint damage, and increased risk of subsequent injuries, such as meniscal tears or cartilage damage. Symptoms typically include pain, swelling, and a feeling of instability in the knee, particularly during activities requiring pivoting or quick changes in direction.

ACL reconstruction involves the replacement of the torn ligament with a graft, often sourced from the patient's hamstring or patellar tendon, or in some cases, from a donor. The surgery is performed arthroscopically (key hole) with a small open incision to harvest the graft. The surgeon makes small incisions to access the knee joint, removes the torn ACL, and places the graft in its position. The graft is secured with screws or other fixation devices to facilitate the integration of new tissue. Postoperative rehabilitation, including physical therapy and a gradual return to activities, is essential for a successful recovery and optimal long-term joint function. Early intervention and appropriate management are crucial to prevent further damage and enable individuals to return to an active lifestyle with a stable and functional knee.


The recovery following an anterior cruciate ligament (ACL) reconstruction is a gradual process, and individual experiences can vary. Here is a general overview of the recovery timeline:

Immediate Postoperative Period (Days 1-2)

Patients typically stay in the hospital for a short duration or may undergo the procedure as an outpatient.

Pain management is initiated to control discomfort.

Initial focus on reducing swelling and starting gentle range of motion exercises.

Weeks 1-6

Crutches are often used initially to aid walking.

Physical therapy begins to regain knee mobility, strength, and control.

Early weight-bearing and exercises to improve quadriceps activation.

Weeks 6-12

Gradual progression of weight-bearing and walking without crutches.

Intensified physical therapy focusing on strengthening the muscles around the knee and improving balance.

Introduction of controlled and supervised exercises to promote knee stability.

Months 3-6

Continued strengthening exercises with an emphasis on functional activities.

Gradual return to more complex movements, agility exercises, and light sports-specific training.

Focus on improving proprioception and neuromuscular control.

Months 6-9

Progressive return to sport-specific activities under the guidance of the healthcare team.

Continued emphasis on strengthening, conditioning, and preventing re-injury.

Monitoring for any signs of persistent symptoms or complications.

Months 9 and Beyond

Full return to sports and higher-impact activities, depending on individual progress and the surgeon’s recommendations.

Maintenance of strength and conditioning to support long-term joint health.

Adherence to the prescribed rehabilitation plan, including physical therapy exercises and activity restrictions, is crucial for optimizing recovery and achieving the best long-term results. Returning to activities too quickly can increase the risk of re-injury, so a gradual and systematic approach to rehabilitation is essential. 


Meniscal tears are common knee injuries, often caused by twisting or direct trauma to the knee joint, commonly occurring during sports activities. The meniscus is a wedge-shaped cartilage that acts as a cushion and stabilizer in the knee. The natural history of a meniscal tear involves the gradual progression of symptoms, including pain, swelling, and decreased range of motion. As the tear worsens, individuals may experience locking or catching sensations in the knee, limiting normal movement. Treatment for meniscal tears depends on factors such as the tear's location, size, and severity. Conservative approaches include rest along with physical therapy to strengthen surrounding muscles. In cases where conservative methods are ineffective, or for more severe tears, arthroscopic surgery may be recommended to repair or trim the torn meniscus. Early diagnosis and appropriate management are essential to prevent further damage and promote optimal knee function.

Meniscal repair is a surgical procedure performed to address a torn meniscus in the knee. The meniscus is a wedge-shaped cartilage that acts as a cushion and stabilizer between the femur (thigh bone) and tibia (shin bone) in the knee joint. When a meniscus tear occurs, particularly in the vascularized outer region (known as the red-red or red-white zone), there is potential for healing. Meniscal repair involves bringing the torn edges of the meniscus back together and securing them in place to facilitate the natural healing process.

During the procedure, the surgeon may use sutures, anchors, or other fixation devices to secure the torn meniscal tissue. The goal is to restore the meniscus to its normal anatomy, preserving its function in cushioning the joint and preventing further degeneration. Meniscal repair is often preferred over meniscectomy (removal of the torn part) when feasible, as it aims to maintain the structural integrity of the meniscus and reduce the risk of long-term joint issues.

Recovery following meniscal repair involves a period of protected weight-bearing, physical therapy, and a gradual return to activities. The success of the procedure depends on factors such as the type and location of the tear, patient age, and adherence to postoperative rehabilitation. Not all meniscal tears are amenable to repair, and the decision to pursue this surgical option is made based on careful evaluation by the orthopedic surgeon.