Cartilage Repair Using Autologous Chondrocyte | HC Chang Orthopaedic Surgery

Full thickness cartilage defect of the knee can be repaired using Matrix-induced Autologous Chondrocyte Implantation (MACI). What is MACI? MACI implant is a 20cm2 (5 x 4cm) Type I/III collagen membrane seeded with up to 20 million autologous chondrocytes (living cartilage cells). This works out to approximately 1 million cells per cm2. The implant is … Continue reading

Treatment Options for Cartilage Damage | Cartilage Defects of the Knee

What is Cartilage? A type of tissue primarily found in the joints Fibrous, elastic tissue covering the bone surfaces in a joint. It has a sliding and impact-absorbing function. Smooth, slippery substance preventing the ends of bones from rubbing together. Unlike bone, cartilage does not contain blood vessels and lacks the ability to regenerate. It … Continue reading

Recurrent Kneecap Dislocations – The Role of the Medial Patellofemoral Ligament

Conservative (that is non-surgical) treatment of acute kneecap dislocation •Re-dislocation rates after conservative treatment of acute lateral patellar dislocation varies from 15 – 63% – Cofield, J Trauma 1977 – Larsen, CORR 1982 – Hawkins, AJSM 1986 – Hughston, AJSM 1988 – Cash, AJSM 1988 Acute Surgical Repair •Using various surgical methods •Re-dislocation rates less … Continue reading

Patellar Dislocations – What, Why, Who and What to Do.

What is a dislocated patella? A dislocated kneecap (patella) occurs when the kneecap (patella) pops out from its normal position. This can occur as the result of trauma or it can be  due to a developmental condition that leads to an improper alignment of the kneecap with the distal thighbone (femur). The kneecap usually pops … Continue reading

Treatment of Combined ACL and MCL Tears in a Knee Joint

Anterior cruciate ligament (ACL) tears are commonly associated with medial collateral ligament (MCL) injuries.  This is due to the common mechanism of ACL injury involving the knee going into valgus with rotation. Most medial collateral ligament tears have the potential to heal over the initial 6 weeks after the injury. However in some type 2 … Continue reading

Hip Replacement for Hip Pain from Osteoarthritis

Hip osteoarthritis is not that common in Singapore.  Knee osteoarthritis is much more common. Hip osteoarthritis can be due to: Primary hip osteoarthritis from wear and tear. From previous hip fracture. Avascular necrosis of the hip i.e. the blood supply to the femoral head is disrupted From hip dysplasia i.e. the socket of the hip … Continue reading

Meniscus Transplant

This patient tore his medial meniscus and had a subtotal medial meniscectomy (most of his medial meniscus shock absorber was removed surgically).   A medial meniscus transplantation was performed.   For information on meniscus transplantations, please contact Dr Chang at 683 666 36 or email Do visit our website at

A Rare Form of Soccer Injury – Rectus Femoris Tendon Rupture

Rectus Femoris Tendon Rupture A rectus femoris rupture is the full or partial rupture of the upper part of the the thin muscle that goes from the front side of the hip to the knee. The main causes of rectus femoris ruptures are explosive kicking techniques. The rectus femoris muscle is composed of fibers appropriate … Continue reading

Hoffa’s Syndrome | Fat Pad Impingement Syndrome – A Cause of Anterior Knee Pain

What is Fat Pad Impingement? Sometimes after a forceful direct impact to the kneecap, the fat pad can become impinged (pinched) between the distal thigh bone ( femoral condyle) and the kneecap (patella). As the fat pad is one of the most sensitive structures in the knee, this condition is known to be extremely painful. … Continue reading

Painful Lump Over The Foot – It Could Be Bony Spurs

This is a peculiar situation that presents to my clinic from time to time. The patient complains of a painful swelling over the top of the foot. This lump feels bony and can be “unsightly”. A possible diagnosis is a ganglion.  This is a fluid-filled sac arising next to the joint or tendon sheath. However, … Continue reading