What is knee replacement surgery?
Knee replacement surgery is a common procedure that involves removing the damaged surface of a deteriorating knee and replacing it with an artificial joint.
Each year, there are over 70,000 knee replacements performed in the UK and the number is on the rise1.
Many people suffer from degenerative knee conditions, such as arthritis, which can be controlled by non-surgical methods, for example, painkillers, physiotherapy or joint injections. However, when these treatments are no longer helpful, knee replacement surgery may be the most appropriate option.
Do I need knee replacement surgery?
You may need a knee replacement if you're experiencing reduced mobility, severe pain, stiffness and swelling. You might also notice that everyday tasks, such as walking up and downstairs or carrying shopping, are becoming increasingly difficult.
Not only can a new knee joint make walking easier, but you should feel much less pain and improved mobility. As well as physical improvements to your health, you may find that your mood and mental wellbeing improves after surgery due to the reduction or elimination of pain.
Ultimately, a successful knee replacement can improve your quality of life.
What does knee replacement surgery involve?
The surgery is performed under general anaesthetic or epidural where you're anaesthetised from the waist down only.
Your consultant surgeon will make an incision on the front of the knee and will then remove the damaged bone and cartilage. This will be replaced with an artificial knee joint. The artificial joint can be made of metal, plastic, ceramic or a combination of these materials, and is bonded directly to the bone with acrylic cement or special coating. You and your consultant surgeon will decide what type of artificial joint is right for you.
Are there any alternatives to knee replacement surgery?
There are a number of non-surgical treatment options that can help to manage your pain and discomfort. For example, your doctor may prescribe painkillers and/or anti-inflammatory medicine.
Many people find that physiotherapy can help to manage their symptoms, improving function and helping them to stay more active. Another option is steroid injections into the knee joint, which may also help to reduce pain and stiffness.
Other approaches that can relieve symptoms for some people include dietary supplements, and complementary therapies such as acupuncture, reflexology, aromatherapy and massage therapy.
Although all of these options can help to manage and relieve the symptoms of arthritis, they will not addressing the underlying cause - the damaged joint surface.
Another surgical alternative to a Knee replacement is an Osteotomy. This may be considered if the arthritis is affecting only one side of the knee joint. This operation involves the surgeon cutting the bone and fixing it with metalwork to realign the joint, so the weight is no longer put on the damaged part of the knee.
Is knee replacement surgery painful?
There will be an element of pain following surgery. However you’ll be prescribed the appropriate medication to help limit any post-op pain.
You won’t feel achy like you did before your operation, for example, from arthritis. The pain after surgery will stem from healing and swelling. It’s important to remember that the pain you experience following your operation should lessen day by day.
Taking regular pain relief will help you participate in your physiotherapy sessions and benefit from them. However, if at any time you feel you aren’t getting enough pain relief, your nurse or consultant should be made aware.
What are the risks of knee replacement surgery?
Most people who have knee replacement surgery make a full recovery and don’t experience complications. However, any surgery poses a risk.
Complications of knee replacement surgery can include:
- Damage to nerves
- Damage to blood vessels
- Infection of the surgical wound
- Infection in the knee
- Severe pain, stiffness and loss of use of the knee (Complex Regional Pain Syndrome)
- Loosening of the prothesis
- Rejection of the artificial knee
Although there are many benefits to knee replacement surgery, your consultant surgeon will discuss the potential risks with you.
How long does it take for a knee replacement to heal?
Planning for your discharge starts even before you come into hospital. On average, patients are in a BMI hospital for two to three days. However, some patients are now offered the opportunity to go home on the same day of surgery.
You'll need to use crutches or walking sticks for a few weeks and a physiotherapist will help you strengthen your knee with specific exercises. This will help you return to normal activities as soon as possible.
Your recovery will take time and it’s important to balance resting and exercise as instructed. You should also avoid kneeling down as it might be uncomfortable and put pressure on your knee replacement.
You'll be able to stop using walking aids when it feels comfortable to do so. This can range from a few days to six weeks. Although the majority of pain goes away after a few days, it can take several months for a knee replacement to completely heal.
What will my after-care be like?
After-care is an essential part of your recovery. It’s a crucial step to getting the most out of your new knee and helping you get back to day-to-day life.
Once you’ve had your surgery, your physiotherapist will provide you with specific exercises to help strengthen your knee and increase your range of movement. The role your physiotherapist plays will be important in helping you regain your confidence, movement and quality of life as quickly as possible.
You will also have a follow-up appointment with your consultant who will monitor your progress. This is a great opportunity to talk through any questions or concerns you may have during your recovery.
Even when your pain eases and you begin to feel better, it’s still really important to continue with your physiotherapy exercises so you can achieve the best possible outcomes for your new knee.