Knee Replacement

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About knee replacement

Knee replacement surgery –also known as knee arthroplasty – involves replacing damaged knee joints with a prosthetic implant made from metal, ceramic and hard plastic. If the entire knee joint is damaged, you may require a total knee replacement.

If only part of the joint is damaged, you are more likely to need a partial knee replacement. Most prosthetic knee implants last between 15 and 20 years. Revision knee replacement is a surgical procedure to replace a worn out implant

Knee replacement surgery is for patients with severe pain due to arthritis or another serious knee condition. If you have difficulty walking, getting in and out of chairs and going upstairs, you may be a candidate for knee replacement surgery.

The knee has three compartments – the medial, lateral and patellofemoral. In osteoarthritis, it is normally only the medial compartment that is affected. In this case, a partial knee replacement may be used to replace only the damaged compartment. Anterior and posterior cruciate ligaments are normally preserved. Only six to 10 per cent of patients on average are suitable for a partial knee replacement and it is not generally suitable for people with rheumatoid arthritis as normally more than one knee compartment is affected.

In a total knee replacement, all three compartments are replaced and an artificial anterior cruciate ligament is created.

Prior to surgery the condition of your knee will be assessed by an orthopaedic surgeon who will check its strength, stability and range of motion. You may be given an X-ray to ascertain the extent of damage to your knee joint. You may need to make certain adaptations to your home to assist you during your recovery. For example, going upstairs may be difficult at first so you may need to create a bedroom on the ground floor.

Surgery is normally done under general anaesthetic, which means you will be asleep throughout. You will be given intravenous antibiotics via a drip before, during and after the procedure to help prevent infection.

During surgery, your knee will be in a bent position. The surgeon will make an incision of between five and 10 inches along the surface of your knee. Damaged bone and cartilage will be cut away and the knee joint will be prepared for the prosthetic implant, which will be positioned in the place of the joint that has been removed. The artificial joint will be tested before the incision site is closed with sutures. The procedure normally takes around two hours.

Afterwards you will be moved to the recovery room where you will be monitored as you come round from the anaesthetic. You may be given surgical stockings and blood thinning medication to help protect against blood clots. In the days after surgery you will be encouraged to move your foot and ankle to reduce swelling and the chance of blood clots. You will be shown exercises by a physical therapist to build strength and flexibility in your new joint.

You will be able to resume everyday activities within three to six weeks and once healed you may be able to do low-impact sports such as walking, swimming or riding a bike. However, you may not be able to participate in high impact activities such as running or jumping as these will place the implant under too much strain.

Knee replacement surgery helps to relieve the pain of osteoarthritis and other severe knee conditions. It increases mobility and improves quality of life, enabling you to resume many of your normal activities.

Knee replacement surgery is a routine procedure however, as with all surgery, there are some risks, including:

  • Infection – you should seek urgent medical help if you develop a fever or increasing redness or swelling around the site of your surgery. You may need a course of antibiotics or, in the case of severe infection, removal of the implant until the infection has cleared.
  • Blood clots in the veins of the leg or the lungs.
  • Nerve damage.
  • Prosthetic implant wearing out – this may happen over a period of years. Being overweight and participating in high impact activities such as running can speed wear and tear on the artificial implant.

Knee replacement surgery is generally a highly successful procedure. Because more of the bone and soft tissue is preserved during a partial knee replacement there are normally fewer complications, a faster recovery rate and better range of motion overall.

However, there is a higher revision rate of partial knee replacements compared to total knee replacement surgery. It is important that you undergo the correct procedure for your particular condition so the surgeon will spend time beforehand understanding your condition and symptoms.

Whatever your age, our expertise can help you feel healthy, active and pain-free again.