DOCTORS are using pioneering surgery which could revolutionise knee surgery for young people. Broadgreen orthopaedic surgeon John Davidson is utilising zirconium implants which could extend younger people's quality of life by more than a decade. Called Oxinium the new replacement joints have a ceramic coating of oxidised metal created by treating it at high temperatures in a the scientific equivalent of a pressure cooker. This produces incredibly tough outer layer which is resistant to scratches and wear and tear.

Currently, knee replacements are made from a special alloy of cobalt, and chrome which has been around, for 20 years, but they easily become abrasive, damaging polyethylene components of the joints. Doctors have been reluctant to carry out knee replacement operations on anyone younger than their 50s because the current alloys only last for between 10 and 15 years before they need to be replaced. The new zuconium joints can last at least a decade longer, making them ideal for young patients. Knee replacements are given to patients suffering from conditions such as rheumatoid arthritis and osteoarthritis.

If a person has suffered from the problem for most of their lives, leaving their joint replacements too late can prevent them having the operation at all as their muscles have become too stiff, forcing them to use a wheelchair. Mr Davidson carried out three operations yesterday on patients who are all in their 30s.

This is the first time operations using the new substance have been carried out on young patients in the north of England though there has been a handful of procedures in London.

Mr Davidson told the Daily Post: “The current knee replacements work perfectly well and the vast majority last for 15 years, but part of it is plastic and this wears out. “If the cobalt chrome joint gets a scratch on this polyethylene section, it's like a razor blade going over it. “You do get bits of debris in a knee replacement. For example, tiny pieces of the bone cement which is used can be abrasive. “But the new model is more resistant and just forms a trough, rather than a scratch. “Laboratory tests show it is much better - it really is a space age material.” Unlike the usual knee joints. the new material is nickel-free, benefiting those who have an allergy to the metal. One school of thought is that a patient could not have such an allergy to their knee replacement, but Mr Davidson and many of his colleagues say there is evidence some people do experience sore knees after the procedure.

Oxinium is around 50pc more expensive than the usual current joints which cost in the region of £1,500, but the operations will prove cost effective for the NHS due to its longevity and the fact that revision operations, costing thousands of pounds will not be as frequent.

ZIRCONIUM is a a member of the titanium family. Its melting point is 1856C and it boils at 4409C.

As it is very resistant to corrosion it is often used as a coating inside nuclear plants and chemical plants as well as a deoxidiser in steel production. When alloyed with niobium, a metal used as a component in some stainless steels, it is used in superconducting magnets. Zirconium is truly a space-age metal as it is found in certain stars, the sun and meteorites.

The number of knee replacement operations carried out by the NHS will sour over the next six years. An analysis of hospital treatment statistics in England for 1991-2000 found that operations more than doubled in a decade.

1. Mrs Linda Wood

2. Mrs Patricia Tubey

Patient Case Study Mrs Linda Wood

Mrs Linda Wood is a 49 year-old voluntary playgroup leader for the local church. She presented to Mr John Davidson, a leading orthopaedic surgeon, suffering with increasing chronic pain in her left knee for many years. The initial problem occurred when she was knocked down by a car at the age of 8 years and dislocated her knee.

From the age of 18 years Linda underwent various knee operations via arthroscopic surgery to remove old debris from the knee, and steroid injections with the aim of improving movement and pain. These provided temporary relief but over the years her knee had become worn and rough leading to arthritis and chronic pain. This subsequently meant that she had to consider having the knee replaced.

However, at that time Linda was only 47 years old, and would not normally be considered for a knee implant until she was older when there was an increased chance of a traditional implant lasting 12 years, without the need for second surgery.

Linda was surprised when Mr Davidson said she could have a knee replacement, due to the development of Oxinium, a new implant that is more durable than standard implants and therefore suitable for younger patients. Linda was to be the first patient to receive the Oxinium knee with Mr Davidson as the surgeon.

Linda was admitted to the Liverpool and Broadgreen University Hospitals in February 2003, where Mr Davidson performed a total knee replacement using one of the first Oxinium knee implants in the UK.

Considering Linda’s medical history her recovery was remarkable; after only two physiotherapy sessions she was able to walk with sticks after 5 weeks, can climb the stairs again, and walk long distances. She was used to having a plaster cast after previous surgery and was amazed that she didn’t need this after her knee replacement.

Linda comments, “My knee was so painful before the operation that I could not walk up the stairs normally. Also, I am just celebrating 30 years of marriage, and have grandchildren who I want to be able to enjoy and play with while I am young. This knee has meant I can live my life now. I have the same problem in my right knee, but I am so convinced by this knee replacement that Mr Davidson plans to operate on my right knee early next year.”

Patient Case Study - Mrs Patricia Tubey

Mrs Patricia Tubey is 57 years old and used to be a clerical worker in the IVF unit of the Aintree Hospital. She now does voluntary work for Cancer Research UK. She presented to Mr John Davidson, a leading orthopaedic surgeon, after suffering with increasing chronic pain in her right knee since she was in her mid-forties. The initial problem occurred when she broke her femur at the age of 23.

For the last 10-12 years she has had steroid injections to help reduce the pain in her knee.Patricia read an article in the ‘Liverpool Echo’ about Mr Davidson and the Oxinium Knee Replacement, which prompted her to contact her GP who arranged a consultation for her.

Patricia was admitted to the Liverpool and Broadgreen University Hospitals at the end of April 2004, where Mr Davidson performed a total knee replacement using one of the newly available Oxinium knee implants.

She made a very quick recovery after the operation within a week she was walking with 2 crutches, and then with just one after 10 days, and after 2 weeks she could walk unaided. She now only has a scar that is fading fast.

Incredibly only two months after her surgery, in July 2004 Patricia was able to go on holiday to Lake Maggiore, Italy, where she joined her husband on mountain walks, the first time in years that she was able to do this.

Patricia comments, “My knee was so painful before the operation that I could hardly walk to the local shops. I found gardening painful and had given up all sport except swimming. On holidays I couldn’t accompany my husband on walks to discover the local area, I used to just sit and wait for his return. But now that I am fully mobile I can enjoy life to the full again. We can also plan holidays in advance, which we couldn’t do before my operation in fact we are considering a trip to Canada next year.”