Here are some of the key things you need to know about total knee replacement surgery. We aim to provide a general overview, but your own orthopaedic surgeon will be able to offer more personalised information that is specific to you.
What is a total knee replacement?
A total knee replacement (also referred to as total knee arthroplasty) is a routine surgical procedure to remove a severely damaged knee joint and replace it with an artificial (prosthetic) implant. There are currently more than 100,000 knee replacements in the UK each year. By the year 2060, The Royal College of Surgeons estimates that the number of total knee replacements will have risen by more than a third (36.6%) compared to 2018 levels.
How does a total knee replacement differ from a partial knee replacement?
The knee is made up of three compartments – the medial compartment (inside of the knee), the lateral compartment (outside of the knee) and the patellofemoral compartment (front of the knee). Osteoarthritis is the most common reason why the knee joint becomes damaged, but the condition doesn’t always affect every compartment of the knee. In some cases, only one compartment is affected, usually the medial compartment but less commonly the lateral compartment. If this is the case, you may be offered a partial knee replacement rather than a total knee replacement. As the name suggests, this involves replacing only one of the components of the knee rather than the entire knee joint. There are pros and cons to both partial and total knee replacements and your orthopaedic surgeon will discuss these with you in detail.
Why have I been offered a total knee replacement?
If you have been offered a total knee replacement, you have severe damage to your knee joint as the result of arthritis or injury. This damage is in more than one of the components of your knee so the surgeon is recommending replacing the entire knee joint with a prosthetic implant. The most common causes of severe knee pain and disability are:
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- Osteoarthritis which is the result of wear and tear to your knee joint, often due to ageing. This type of arthritis is most common in people over the age of 50 and it develops when cartilage that cushions the bones and helps the joint to move smoothly becomes worn.
- Rheumatoid arthritis which is an autoimmune condition that causes inflammation in the joint, damaging the cartilage inside the knee.
- Post-traumatic arthritis which can develop following a serious knee injury such as a fracture or ligament tear.
You are likely to be experiencing significant knee pain and stiffness that affects your everyday life. If you have a degenerative condition like osteoarthritis, your symptoms will have been progressively worsening over time and less invasive treatments such as painkilling medication or injections are probably no longer effective.
What happens during the operation?
During a total knee replacement, the damaged ends of the femur and tibia are removed, along with damaged cartilage. These are replaced with metal implants and the underside of the kneecap is, when suitable, resurfaced with smooth plastic. Metal components are separated by medical-grade plastic spacers which helps them to glide smoothly over each other.
What is a Mako total knee replacement?
Total knee replacements have been carried out since the 1960s and over the years the procedure has undergone countless improvements. Mako robotic arm-assisted total knee replacements are the latest technological advance to improve outcomes for patients. Mako technology enables surgeons to personalise the surgery to individual patients based on their unique anatomy and diagnosis. During the procedure itself, a state-of-the-art robotic arm is used by the surgeon to guide them to remove diseased bone and cartilage with pinpoint precision. The greater the degree of precision, the better the likely outcomes so this is a huge advance for joint replacement surgery.
How successful are total knee replacements?
A total knee replacement will enable you to enjoy quality of life again. While the procedure improves mobility and relieves pain, you may not regain the full function of your knee prior to arthritis but you should be able to bend and straighten the knee sufficiently to perform most everyday activities like climbing stairs and getting in and out of cars.
How quickly will I be able to return to work/driving after a total knee replacement?
It will depend on the type of work you do. Office workers can normally return to work within four to six weeks but if your job is more physical you may need up to three months off work. Your orthopaedic surgeon will advise you. Most people can return to driving within four to six weeks after surgery.
What are the risks of total knee replacement?
Although it is a routine procedure, nevertheless a total knee replacement is major surgery and so carries risks. The most serious of these include the risk of developing a blood clot or infection. Your surgical team will monitor you closely while you are in hospital and will advise you of any signs to look out for once you return home. If you are at all concerned, speak to your orthopaedic surgeon. The full risks will be discussed and documented in your consultation clinic letter.
How long will my knee implant last?
Most total knee replacements will last at least 15 years after surgery. Eventually all prosthetic implants will fail and, once this happens, you may need revision joint replacement which means removing the original implant and replacing it with a new one.
What patients say…
“I had a very successful right TKR (Total Knee Replacement) in November last year under Mr Carrothers and felt slightly apprehensive about undergoing a left knee TKR four and a half months later, but I am now 4 weeks post op and my recovery and rehab is going well. This time round I rented a Game Ready (gameready.co.uk) straight knee wrap which combines intermittent compression with cold therapy, and feel this has made a significant difference to my post op recovery with reduced swelling, reduced bruising and reduced requirement for pain killers. I see Mr Carrothers in two weeks time for my 6 week post op follow up and hopefully he will be as pleased as I am with this early stage recovery.”
Written by a private patient at Nuffield Hospital Cambridge, 27 April 2023
Talk to an orthopaedic consultant | Cambridge
We are always happy to provide information and guidance about the various treatment options, both surgical and non-surgical, including Mako robotic arm assisted surgery and conventional surgery.
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For your convenience, we offer appointments at both Nuffield Hospital Cambridge and Spire Cambridge Lea Hospital.
