Knee Replacement Surgery
Knee replacement surgery – otherwise known as arthroplasty – is an operation which involves the replacement of a damaged or worn knee with an artificial joint. This is a procedure which can become necessary at any age, due to ageing, injury or disease, and is required when the current knee has deteriorated to the point where your mobility has been sufficiently reduced and you are experiencing pain that is impacting your quality of life.
WHAT HAPPENS DURING KNEE REPLACEMENT SURGERY?
After a course of general anaesthetic or an epidural injection, the knee joint is accessed in order to get at and smooth off the roughened and worn-out ends of the femur and tibia and prepare the bones for the new joint.
The next stage involves preparing the areas around the knee for the new joint. In some instances – where the bones have become more worn on one side or the other – this anomaly will be corrected to make sure the leg is straight by the end of the procedure.
The ends of the bone are resurfaced with metal prostheses, a flat plate on the top of the tibia, and a contoured cam for the end of the femur. A plastic bearing is then fitted between the metal surfaces – producing a very smooth surface which allows the joint to bend, straighten and twist. In some cases, the back of the kneecap will be replaced with a plastic button. This procedure is known as a total knee replacement or TKR.
If the wear in the knee is only present in one half of the knee, then it’s commonplace for a half-replacement which leaves the remaining normal knee surfaces untouched. This is known as unicompartmental knee replacement (UKR), and the advantages in it are that patients tend to recover slightly quicker, and are more likely to feel like it is still their own knee rather than a replacement.
WHAT HAPPENS AFTER KNEE REPLACEMENT SURGERY?
After the operation, a dressing is fitted around your knee, to protect a tube which will drain off blood from your knee. This will be in place for the first 24 hours after your operation, and the blood can be filtered and put back into your body via a drip – reducing the need for a post-operative blood transfusion.
Once the drain has been removed and you have fully recovered from the anaesthetic, you will be invited to test out the replacement by walking around, under the supervision of the ward physiotherapists. By this time, you’ll be able to fully bear your weight on the operated leg, but will need to use a pair of crutches or walking sticks in the early stages of your recovery.
You will be offered painkillers to enable you to sleep comfortably and begin exercising your knee effectively. It’s vital that your pain levels are well controlled following surgery: if you feel excess pain, the ward staff must be alerted. When not walking or exercised, the leg must be kept in an elevated position. You will also be instructed on how to ice the knee properly after you leave the surgery and recover at home, along with being provided with a regime of simple exercises which will help get your knee comfortably moving again, strengthen your muscles and aid your circulation.
Once you are able to walk comfortably and safely, both on flat ground and on the stairs and you have achieved a satisfactory range of movement in your knee, you will be ready to return home. The average stay in hospital after TKR is four nights and after UKR is three nights.
If an enhanced recovery programme is suitable, then you will start walking on the day of your procedure and discharged within one to three days.
GETTING AROUND AFTER KNEE REPLACEMENT SURGERY
Most patients are keen to know how quickly they will be able to resume normal life after knee replacement surgery. Most usual daily activities can be performed within six weeks of surgery, but pain and swelling can still be a factor for up to three months after.
For up to two years after your operation, your knee will continue to recovery, with scar tissue healing and the muscles around the knee returning to full function. Mr Jonathan Webb’s team will advise you on the physiotherapy required to strengthen the knee as well as stretch the limb to stop scar tissue from overdeveloping and inhibiting a full range of movement.
WHAT OUR PATIENTS SAY ABOUT THEIR KNEE REPLACEMENT SURGERY
“Great news; my new half knees are absolutely fantastic and they amaze everyone, especially me!”
“Thank you so much for this and for the treatment I’ve had over the last few months. I’m overjoyed at how smoothly the recovery has been and how pleased Jonathan is with my knee – it was a massive boost to my confidence.”
“Thanks again for helping me along the way to achieve something that wouldn’t have been possible without your support.”