Knee replacement surgery

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Do I need a knee replacement?

You’ll only need a knee replacement if your knee gives you pain, stiffness, instability or loss of function that affects your daily life and activities. Your orthopaedic surgeon will be able to advise you on the surgical options and on the potential pros and cons of having or delaying surgery.

What are the different types of knee replacement surgery?

What are the possible advantages of knee replacement surgery?

Possible advantages of knee replacement surgery can include:
  • freedom from pain
  • improved mobility
  • improved quality of life.

What are the possible disadvantages of a knee replacement?

Possible disadvantages of knee replacement surgery can include:
  • replacement joints never being as good as your natural knee and wearing out after a time
  • difficulties with some movements
  • clicking or clunking in the knee replacement
  • numbness.

What are the alternatives to knee replacement surgery?

Most doctors recommend non-surgical (conservative) treatments before considering a knee replacement, including:

  • weight loss
  • exercise
  • drugs.

Alternative surgical options can be considered if other methods haven't worked. These include:

  • arthroscopic washout and debridement
  • microfracture
  • osteotomy
  • autologous chondrocyte thearpy (ACT).

How should I prepare for knee replacement surgery?

You may be invited to a pre-admission clinic a few weeks before surgery. You should ask any questions you have here, including about changing the dosage of any medication you take, and your general fitness will be assessed. You'll usually be admitted to hospital on the day of your operation.

What will my recovery from knee replacement surgery involve?

Most people can leave hospital between one and four days after having knee replacement surgery. You'll need to make arrangements for wound care and you'll usually have follow-up appointments from six weeks after your operation. A physiotherapist or occupational therapist will be available to advise on daily activities and you should be able to return to work within six to eight weeks, depending on your job.

Looking after your knee replacement

Your new knee will continue to improve for as much as two years after your operation. You'll need to restore your muscles through exercise and pay attention to any problems such as:

  • stiffness
  • pain
  • infection.

You’ll also need to take care in the first few weeks when moving around and doing household jobs so that you don’t damage your new knee. You'll need to use crutches for a few weeks to reduce the risk of falling.

What about exercise following a knee replacement?

Cycling is a very good way of building up strength and mobility after surgery. Exercises that impact on your joints aren’t recommended.

What are the possible complications of a knee replacement?

Most knee joint operations are problem-free but complications arise in about 1 in 20 cases. Possible complications can include:
  • blood clots
  • wound haematoma (bleeding)
  • infection
  • dislocation
  • bone fracture, nerve or ligament damage
  • wear
  • loosening
  • stiffness
  • pain.

Contact a healthcare professional straight away if you:

  • have any hot, reddened, hard or painful areas in your legs in the first few weeks after your operation
  • experience chest pains and/or breathlessness.

How long will the new knee joint last?

Knee replacements last for at least 20 years in 80–90% of patients. In more active patients the joints may wear out more quickly. However, it’s usually possible to have further knee replacements.

Research and new developments for knee replacement surgery

Studies into knee replacement are looking at:
  • image-guided surgery
  • robotic surgery
  • cementless knee replacements.

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No pain, no gain

Michael Donnelly and Emma Fuller

Knee replacement surgery can reduce pain and improve quality of life – but not for everyone. Jane Tadman reports on how intensive post-operative physiotherapy could play an important part in ensuring a better success rate.