Knee Replacement Surgery
Relieving Pain and Restoring Function
Knee replacement surgery, also known as arthroplasty, is an operation where an artificial (prosthetic) joint will replace all or part of a damaged knee. There are two types of knee replacement surgery;
Total Knee Replacement – where the surgeon replaces both sides of the knee joint.
Partial Knee Replacement – where the surgeon replaces only one side of the joint in a smaller and shorter operation.
When Is Knee Replacement Surgery Needed?
Knee replacement surgery resurfaces parts of the knee that are damaged which can help to relieve knee pain, discomfort and can increase mobility.
Often this type of surgery is offered to relieve knee problems associated with severe arthritis (osteoarthritis), a serious knee injury, deformity or disease process (such as rheumatoid arthritis, haemophilia, gout, bone dysplasia and avascular necrosis) which are associated with a great deal of pain and a loss of cartilage.
Mr. Williams will consider offering a knee replacement surgery when;
- severe knee pain, swelling and stiffness is interfering with the quality of life and sleep
- the pain makes everyday tasks difficult or even impossible
- patients suffer depression because of the lack of pain and mobility
- there is a reduction in mobility
The aim is to replace a knee joint that is painful, stiff and often deformed with one that is pain-free, moves easily and is correctly aligned.
What Happens During Surgery?
The operation is performed either under general anaesthetic, where you are asleep throughout or under spinal anaesthetic, where you have no feeling from the waist down. Mr. Williams will then make an incision and remove the worn ends of the bones in the joint and replace the joint with a prosthesis.
The prosthesis, or artificial joint, is comprised of metal and plastic parts that attach to the bones and is accurately measured to fit your knee. Mr. Williams only uses implants which meet the highest level of independently evaluated UK standards called ODEP 10A* implants.
It should also be noted that Mr. Williams is a strong advocate of modern enhanced recovery protocols (ERAS) which includes infiltrating the operated area with local anaesthetic to improve the post operative experience.
What happens after the operation?
You will be transferred to the recovery room where you will remain until Mr. Williams and the anesthetist are satisfied that you have recovered sufficiently before you are transferred back to the ward.
Pain relief after the operation
Good pain relief is important and some people need more pain relief than others. It is much easier to relieve pain if it is dealt with before it gets bad. Pain relief can be increased, given more often, or given in different combinations. You should ask for help if you feel pain.
Physical activities after your operation
A physiotherapist will visit you pre-surgery, and immediately after your surgery and begin teaching you how to use your new knee. You will start to put your full weight on the knee with the support of a frame and then crutches even on the day of surgery, with the objective of achieving a range of movement between a straight leg (full extension) and bend of more than 90 degrees (flexion 90 degrees) before you are discharged home a few days later.
General advice for when you go home
You can expect some pain but not the same sort of pain as you had before the operation. The time it lasts will vary from a few days, to several weeks; everyone is different. It is important to take your painkillers as advised.
Swelling and bruising may take up to 8 weeks to disappear; for some it can last up to 6 months.
One of Mr. Williams nurses will keep in touch with you by phone and a follow-up appointment 6 to 8 weeks after surgery will have been booked prior to your operation.
After your skin clips have been removed you can have a shower or bath once we have shown you how to use it safely. Until then your wound will need to stay covered with a dressing.
Try to gradually increase your activity each day by walking as well as continuing your exercises.
You must not drive or resume any sporting or gardening activities until you have seen Mr. Williams and he has cleared you to do so.
This is a very successful operation, but there are some risks associated with any procedure. For a knee replacement they include:
- Anaesthetic – Modern anaesthetics are generally very safe. The anaesthetist will explain any particular risks to you.
- Infection – There is a small risk of infection of the joint following the operation but you will be given antibiotics to help prevent this. If after you get home you notice fever, increased pain, swelling and redness around the wound, please phone contact our office.
- Deep vein thrombosis (a blood clot in a leg vein) – You may have anti- coagulant medication and support stockings to help prevent it. A symptom of this may be an acute pain in your calf. Please contact us urgently.
- Loosening – Your new knee may become loose with time or eventually wear out and need to be replaced.
- Numbness – there is typically numbness on the outer side of the knee. This relates to the small skin nerves that have to be cut during the operation. Some of this numbness, but not all, will recover. It should not stop you from kneeling if you wish to kneel.
What Are The Limitations?
As the a knee replacement is considered major surgery, it is important that Mr. Williams believes you are well enough to cope with the procedure and with the rehabilitation afterwards. Before the procedure, Mr. Williams will talk comprehensively with you about the surgery and the recovery and will answer all the questions you may have.
Knee Replacement Follow-up Program
It is generally accepted that knee replacements should be kept under surveillance so that potential problems are identified at an early stage. The surgical wound will need to be reviewed by a nurse 10-14 days post operativley. A member of Mr. Williams team will also telephone you a few days after discharge to check that all is well. At 6 to 8 weeks post operativley, Mr. Williams will review your progress during a follow-up consultation.
Following this, below is a summary of when each review should take place
- X- ray and clinical assessment 1 year after surgery
- X- ray every two years after that
- Yearly questionnaire
Repeat clinical assessment at 5 years, 10 years and 15 years…..
A discussion will be had whether you would like the long term follow up to be performed at BMI Werndale or within the NHS.
It may be worth reading the excellent NHS Guide to Knee Replacements.
Make an Enquiry
If you are looking at the options and would like to enquire about treatment, or an appointment send a messaage here: