Knee replacement surgery involves removing the damaged joint surfaces and replacing them with prosthetic components that are designed to replicate the natural, near frictionless motion of a healthy knee.
As a Sydney-based orthopaedic surgeon with over 15 years of experience in knee replacement surgery, Dr Anthony Keeley offers personalised treatment using the latest surgical techniques to help patients regain mobility and function, and to improve their quality of life. From assessment through to surgery and rehabilitation, Dr Keeley’s focus is always on achieving a stable, natural-feeling knee that supports daily movement, work, and activity.
The most common reason for knee replacement, osteoarthritis is a degenerative joint disease that leads to the breakdown of cartilage and underlying bone.
An autoimmune condition that causes chronic inflammation of the knee joint lining (synovium), leading to pain, swelling and joint erosion.
Arthritis that develops after a knee injury, such as a fracture, ligament tear or meniscus injury.
A condition in which poor blood supply leads to the death of bone around the knee joint.
Advancements in technology and surgical techniques have made knee replacement more accurate, efficient, and patient-specific. Dr Keeley has trained in multiple modern approaches and techniques, including robotic assisted, computer navigated, and patient specific instrumentation, as well as measured resection/caliper verification using a kinematic alignment philosophy. Dr Keeley believes that the best of these approaches is kinematically aligned, caliper verified technique.
This technology uses infrared sensors or motion sensors to guide the surgeon during surgery, helping ensure the implant is aligned correctly relative to the patient’s anatomy.
PSI uses pre-operative imaging (such as MRI or CT) to design custom cutting guides for the patient’s unique anatomy, which assists making accurate bone cuts intra-operatively, based on a pre-operative plan.
This is Dr Keeley’s preferred technique for knee replacement surgery. It combines the precision of measured resection and caliper verification with the philosophy of kinematic alignment to restore the patient’s natural joint anatomy and motion.
Dr Keeley’s preferred technique is caliper-verified measured resection using kinematic alignment principles. This method prioritises restoring each patient’s natural limb alignment, joint anatomy and movement pattern, rather than forcing the knee into a generic “mechanical alignment”.
Kinematic alignment seeks to match the natural limb and joint alignment and movement axis of your knee by positioning the prosthetic components to replicate your original joint anatomy. Unlike traditional techniques that aim to create a “one-size-fits-all” mechanical axis and joint line, kinematic alignment respects the individual’s natural joint structure.
During surgery, specialised precision jigs are used to cut the bone and/or cartilage to an exact thickness, aiming to match exactly the thickness of the prosthesis, such that the new prosthetic joint surface is positioned in exactly the same place as the original joint surface. This restores patient specific alignment of the joint line and lower limb. Precision calipers are used to verify the thickness of each bone resection, ensuring accuracy of resection thickness, usually within 0.5mm.. This attention to accuracy is critical in achieving optimal balance and excellent functional outcomes.
A growing body of research supports kinematic alignment, and many Australian surgeons are now adopting this technique for its ability to deliver more “patient-specific” results, less post-operative stiffness, better functional outcomes, faster return to activities, and overall higher rates of patient satisfaction compared to alternative approaches.
Dr Keeley’s use of measured resection with caliper verification further elevates the precision of the procedure, making it one of the most refined and tailored approaches currently available.
Whether you are looking to relieve long-standing pain or return to an active lifestyle, you’ll receive expert, compassionate care every step of the way.