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Knee replacement
Knee replacement is a surgical operation that involves replacing worn, damaged or diseased knee with an artificial joint made of metal and plastic. Knee replacement surgery is generally used when other non-surgical treatments have failed. The operation can relieve pain, improve your mobility and the quality of life.
You should consider a knee replacement surgery if you have these symptoms:
• persistent pain, swelling and stiffness in your knee joint and your mobility is reduced and you are in pain even when resting
• knee inflammation or deformity
The most common reason for knee replacement surgery is osteoarthritis. Osteoarthritis is a degenerative joint disease caused by a worn cartilage, and the thigh bone and shin bone rubbing together.
Most patients who undergo total knee replacement surgery are between the age of 60 and 80 and are with degenerative arthritis but adults of any age can be considered for this operation. It is recommended to replace a knee implant every 10 years, but nowadays modern prosthesis have longer lifetime.
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Who is it suitable for
✔ People diagnosed with chronic osteoarthritis
✔ Those who had serious knee injury
✔ Individuals with gout, haemophilia or bone dysplasia
✔ People experiencing severe knee pain, stiffness or inflammation
✔ Knee replacement is recommended when alternative therapies such as physiotherapy or steroid injections have failed
Treatment duration
Recovery
✔ A knee replacement surgery normally takes around 2-3 hours
✔ Most patients need to stay in hospital overnight
✔ The complexity and duration of knee replacement vary from patient to patient, depending on their individual situation
✔ Most patients can go home 3 days after surgery
✔ Rehabilitation will be needed for at least 6-8 weeks
✔ Most patients can resume daily activities such as walking within 3 to 6 weeks
✔ Pain and inflammation may last for 3 to 4 months after surgery
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Types of knee replacement surgery
The four main types of knee replacement surgery are:
• total knee replacement
• unicompartmental (partial) knee replacement
• kneecap replacement (patellofemoral arthroplasty)
• complex or revision knee replacement.
There are several kinds of replacement knee joint as well as different surgical methods. Your doctor and orthopaedic surgeon should help you to choose the best option for you, taking into account the condition of your knee and your general health.
Can I have both knees replaced at the same time?
Yes. If you need to replace both knees, you can choose for either a simultaneous bilateral knee replacement (both knees replaced during the same surgery) or a staged bilateral knee replacement (two surgeries performed a few months apart). Discuss it with your doctor for better results.
Before The Treatment
Before the surgery you will meet your surgeon to discuss your surgery objectives and perform an examination:
• Goals and expectations - Your surgeon will likely ask you why do you want a surgery and what are your expectations. A surgeon should explain you potential risks, recovery and expected outcomes.
• Medical history - You should provide a complete medical history including your past and current medical conditions, chronic illnesses, previous surgeries, traumas and injuries. A doctor will ask about your knee pain, mobility as well as other symptoms, and how it affects your daily life.
• Medication review - Prepare to provide a list of medications that you might be taking including prescription drugs, supplements, over the counter medication and anything else that you are taking regularly.
• Examination - A surgeon will examine your before surgery and assess knee motion, strength and the overall alignment of your legs.
• Diagnostics, tests and additional examination - It is likely that you will be asked to do an X-ray and/or MRI (magnetic resonance imaging) to determine the extent of the knee problem and it's deformity. Be prepared to undertake additional examination, diagnostics, a specialist consultation and blood tests if your surgeon requests before preceding with this treatment.
Before the surgery you will be advised by your surgeon how to prepare for this procedure, which may include dietary requirements and medication directions. It's recommended that you arrange for help during recovery and drive you home from a hospital.
What does it involve?
There are different types of knee replacement, but generally the following is involved:
• This procedure is generally performed under general or spinal anaesthetic.
• The knee replacement procedure will start with making incisions around the treated area.
• Joint damaged parts (surfaces) are then removed and artificial prothesis is placed. There are different types of prothesis available nowadays on the market, so you can discuss which kind of prosthesis will be placed in your case with your doctor before surgery.
• Drain tubes may be placed through the incision to drain any excess fluid and blood.
• At the end, sutures are applied to close the incisions.
• A bandage may be applied to reduce swelling and bruising.
• Compression socking can be applied to reduce DVT risk.
Knee replacement procedure usually takes 2 to 3 hours but may take longer. In most cases, patients have to stay in hospital overnight, and then will have to go through rehabilitation process until full recovery.
After the treatment
Depending on the complexity of the operation and your situation you may need to stay in hospital for 3 to 5 days. After surgery you will be placed in a post-surgery care unit where a medical team will be monitoring your vital signs and help you manage pain and any other post-surgery symptoms. Once you are in a stable condition you will be moved to an inpatient room for further recovery.
At the hospital you will be given advise about recovery and how to look after your knee. Your therapist will help you sit up, get in and out of bed, and practice walking and climbing stairs using a walker, cane or sometimes crutches.​ Most patients can start walking with aid within day or two after surgery. Your doctor will monitor your recovery and use a multifaceted approach to ensure comfort and mobility during the rehabilitation process.
It is recommended that patients continue rehabilitation process and exercise with a physiotherapists for at least 6 to 8 weeks after surgery to ensure better results and quicker recovery.
After 2 or 3 months most patients are able to resume everyday activities. Full recovery can take up to couple of years.
Risks
Knee replacement surgery is considered safe and effective. However, very rarely, complications can include:
• infections
• blood clots (deep vein thrombosis, or DVT)
• nerve and blood vessel injury
• swelling and stiffness
• continued pain
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