If you have a damaged knee joint, you may require knee replacement surgery to replace the damaged elements with artificial parts. Knee replacement surgery is a common procedure carrying minimal risks.
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What is knee replacement surgery?
Knee replacement surgery is a surgical procedure that involves replacing damaged parts of the knee joint with artificial parts, most commonly metal or plastic. Depending on the reason for the procedure and the extent of the damage, surgeons may need to undertake a full or partial knee replacement.
Why might you need knee replacement surgery?
Most people who need knee replacement surgery undergo the procedure due to significant pain in the knee. This is commonly caused by osteoarthritis, a condition that causes stiffness and pain in the joints.
Knee replacement surgery is often a last resort procedure. Doctors typically recommend other lifestyle changes first, such as physical therapy, weight management, or injections. However, if these do not work, knee replacement surgery will be required.
In some cases, although rare, knee replacement surgery can be used to treat sports injuries or gout.
Types of knee replacement surgery
There are two main types of knee replacement surgery that can be carried out. Surgeons will assess the knee joints and symptoms before establishing whether a total or partial knee replacement is needed.
Total knee replacement
A total knee replacement is the most common of the two types. During this procedure, surgeons replace the lower end of your thigh bone and the upper part of your shin bone with metal or plastic parts.
Typically, an incision is made to the front of the knee before the kneecap is moved out of the way for easy access to the joints located behind. Next, the damaged ends of the thigh and shin bones are cut away and replaced with artificial parts to create a new joint. After this, surgeons put the kneecap back into place before closing the incision.
Partial knee replacement
A partial knee replacement is carried out in a similar way to a total knee replacement. The key difference is that only the affected bones are replaced. For example, if you have arthritis in the lower part of your knee, the joint at the shin side of your knee will be replaced, and not the thigh.
Recovery is often a little quicker for a partial knee replacement since the incision is smaller and less work is required.
Preparing for knee replacement surgery
When a knee replacement is discussed with your doctor, you will be advised on preparing for surgery. This often includes managing your weight, maintaining a healthy diet, stopping smoking, and doing exercises that can help you both before and after your procedure.
Before your knee replacement surgery, you may also be called in for blood tests and blood pressure checks to ensure you are fit for surgery. You’ll also have the opportunity to ask questions and learn more about the procedure.
You should also consider recovery in preparation for your knee replacement. Think about how you will get home, changes that need to be made to enable faster recovery, and whether you need to do any batch cooking to support the resting period.
What happens during knee replacement surgery?
On the day of your knee replacement surgery, you will be given either a morning or afternoon slot. When you arrive at the hospital, you will have the chance to discuss the details of your surgery and ensure arrangements are in place for getting home.
Knee replacement surgery is carried out either under general or local anaesthesia. If you are having a general anaesthetic, you will be asleep for the duration of your operation and will need to spend a little more time recovering in hospital before you go home. If a local anaesthetic is being used, this is typically administered in the spine. You will be awake but will have no feeling from the waist down during the procedure.
How long does knee replacement surgery take?
A knee replacement operation usually takes between one and two hours. However, this will depend on the complexity of the surgery, how much damage is present, your age, and general health status.
Recovering from knee replacement surgery
Although knee replacement surgery can be performed as a day case, you may need to spend a couple of days in hospital to ensure you can safely get around after your procedure. After this, the recovery period can last for several months. It will take time for you to get used to using your new joint, so it’s important to take things slowly.
Immediately after your operation, you’ll spend some time in the hospital to recover from your anaesthesia and ensure everything has gone well. During this time, you will be given medication to help with pain relief. Nurses and physiotherapists will also be on hand to support you with walking after your operation, making sure you feel stable enough to go home.
Knee replacement surgery can be painful, so you should continue using pain relief medication at home to manage soreness in the knee area. Your doctor will also provide you with physiotherapy exercises, which will help to speed up recovery and enhance long-term strength and mobility in the knee.
You will typically have any stitches or clips removed around 10 days after your surgery, and follow-up appointments will be required to check on your progress.
Top tips for knee replacement recovery
To encourage faster healing after a knee replacement surgery, it’s important to follow the guidance provided by your surgeon and doctor. Some things to consider when recovering include:
- Completing physiotherapy exercises
- Drinking plenty of water
- Using pain relief when needed
- Maintaining a healthy diet and weight
- Keeping the leg elevated to avoid swelling
- Walking around little and often to prevent blood clots and encourage healing
- Avoiding kneeling in the first few months
- Using a walking frame or crutches in the initial recovery period to help you get around
- Waiting at least six weeks before driving
- Avoiding twisting your knee, bending, or stretching too much
Potential complications of knee replacement surgery
Knee replacement surgery is a common and safe procedure, but it’s important to be aware of potential complications both during and after your surgery. In many cases, complications are minor and can be treated. However, the risk of complications does increase with age and general health status, and how well you look after your new knee.
The main knee replacement complications to look out for include:
- Blood clots or deep vein thrombosis (DVT)
- Damage to tissue or nerves
- Infection around the wound
- Knee stiffness, pain, or problems bending the knee
Most of these complications can be treated by your doctor, which is why it’s important to stay in regular contact and let them know if any issues occur. You should contact your doctor immediately if you have throbbing or cramping in the leg, a high temperature, oozing from the wound, pain that does not improve, or chills.
What are the alternatives to knee replacement surgery?
Knee replacement surgery is typically advised if other solutions have not worked. Before you undergo a knee replacement surgery, your doctor may suggest:
- Physiotherapy
- Medication
- Lifestyle changes such as weight loss
- Using walking aids
- Corticosteroid injections
Alternative operations may also be an option depending on the severity of your joint pain. Your doctor might discuss an arthroscopy procedure, which is keyhole surgery used when arthritis is bearable but the knees keep locking into place. During this surgery, debris is flushed out, and cartilage may be trimmed to ease pain.
Microfracture can also be used to encourage new cartilage to grow. This keyhole procedure involves surgeons making small holes in the surface layer of your bone to promote cartilage growth.
Knee replacement surgery is a common procedure, with total replacements being undertaken more often than partial.
If you think a knee replacement might be beneficial for you, speak to our Orthopaedic specialists for more information.
