Knee replacement surgery (arthroplasty) is a routine operation to replace damaged, worn or diseased knee joints with artificial ones. Most surgery is performed on people between 60 and 80 years but adults of any age can have a knee replacement.
Knee osteoarthritis is one of the primary reasons that people have knee replacement surgery. This condition can have a huge impact on your life, making it difficult to walk, climb stairs, or even sit or lie down without pain. In the first instance, doctors will recommend a range of non-invasive treatments to help you manage the symptoms.
However, if these don’t work or your quality of life is severely impacted by pain, your doctor may recommend knee replacement surgery.
Other conditions that cause irreparable knee damage include:
- Rheumatoid arthritis
- Gout
- Haemophilia
- Unusual bone growth
- Injury
- Death of bone in the knee joint as a result of blood supply problems
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Benefits of knee replacement
Knee replacement surgery will provide long-term relief from the pain and stiffness of osteoarthritis. It is possible to alleviate many of the symptoms and restore mobility by taking away the damaged or diseased joint and replacing it with an artificial one. On average, knee replacements last 15-20 years if looked after properly. Depending on your age, this may mean the remainder life free from the pain of osteoarthritis.
How it works
Knee replacement surgery entails removing the damaged, worn or diseased joint and replacing it with an artificial joint made of metal and plastic. A total knee replacement involves replacing both the inside or the outside of the knee joint. However, in some cases you may only need a partial knee replacement where only one side of the knee joint is replaced. This is a smaller operation with a shorter recovery period.
There are different types of knee replacement surgery, including
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- Partial knee replacement The knee has three sections – the inner (medial), outer (lateral) and the kneecap. If only one part of the knee is damaged, you may be offered a partial knee replacement. The benefit of this is that the operation is less invasive so recovery times are quicker. For example, patellofemoral joint replacement is for patients with arthritis of the patellofemoral joint, which is the joint between the kneecap (patella) and the thighbone (femur).
- Total knee replacement A total knee replacement involves replacing a damaged, worn or malformed knee with a complete artificial joint. It involves major surgery, but in the majority of cases results in recovery in mobility, and the reduction or elimination of pain
- Knee realignment (osteotomy) Knee realignment or osteotomy cuts and reshapes the bones to relieve pain. If the kneecap is not quite straight, for example, it can cause pain, which can be worsened by arthritis. A knee osteotomy cuts and reshapes either the tibia (upper shinbone) or femur (lower thighbone) to relieve pressure from the damaged knee joint.
- Revision joint replacement A knee replacement should last 15-20 years, providing it is cared for properly. Even so, it is possible that the artificial joint will wear out at some point, in which case a revision knee replacement may be needed. The revision surgery for knee replacements is more complex than the primary replacement, and at present they do not always last as long. However, it is an increasingly commonplace operation. Read more
- Customised knee replacement Read more
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Risk factors
Knee replacement surgery is a major operation. You will normally be in hospital for three or four days and you will need a walking aid for around four weeks after surgery. You will not be able to drive for 4-6 weeks. Full recovery can take up to two years.
Complications are rare but can include:
- Infection of the wound or joint replacement
- Ligament or nerve damage
- Blood clots or deep vein thrombosis
- Ongoing pain in the knee
- Bleeding in the knee joint
- Fracture of surrounding bones
- Risks from anaesthetic
What does a knee replacement treat?
Knee replacement surgery may be offered to people who:
- Have severe knee pain that limits their everyday activities (walking less than 30 minutes)
- Experience moderate or severe pain and knee stiffness even while resting
- Have long-lasting knee inflammation that doesn’t get better with rest or anti-inflammatories
- Do not respond to pain relief medication
Who it helps
You are likely to offered knee replacement surgery only if other treatments such as physiotherapy or steroid injections haven’t helped.
Knee replacement requires major surgery that is normally only offered if:
- You have severe pain and your mobility is significantly impacted
- Your quality of life is being adversely affected and you are struggling with everyday tasks
- Your work or home life is suffering as a result of your knee problems
- The pain is causing low mood or depression
FAQ’s
How quickly will I be able to go home after surgery?
You can normally go home three to five days after your operation. You will need crutches and your physiotherapist will recommend exercises to strengthen your knee.
How can I prepare for my operation?
It is a good idea to stay as active as you can as strengthening the muscles around your knee will aid your recovery. Gentle exercise is best – swimming and walking. Your physiotherapist will also suggest some exercises to help you prepare for surgery.
What is arthroscopic washout?
Sometimes you may be offered alternatives to surgery. In days gone by an arthroscopic washout and debridement was performed, but it did not give lasting results. Now, arthrscopic surgery is only used in knee arthritis to remove loose bodies that are troublesome or if the knee is locking due to a cartilage tear.
Personal outcomes – what to expect
Each year, knee replacements enable thousands of patients to enjoy an active life, free of chronic knee pain.
Our patient-care process
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- Once all of your diagnostic procedures are completed, we will be able to explain whether surgery is recommended.
- We will go through the procedures with you, covering the operation itself, the recovery process and the future prospects.
- Your orthopaedic surgeon will also explain the risks: these are small, but it is important for you to understand them.
- You can feel reassured that you will receive expert care from the start of the process, including your after-care
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If you are experiencing pain in your pelvis, hip, knee or ankle, or are suffering from a sports injury, seek specialist help to get you back to living your life. Contact can be made direct, or through your GP.
Email:
enquiries@carrothersorthopaedics.co.uk
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