Total Knee Replacement

What is a total knee replacement?

A total knee replacement, also known as knee arthroplasty, is a common surgical procedure that can relieve pain and improve your mobility if you have severe damage to your knee joint. The procedure involves replacing your damaged or worn knee joint with an artificial joint, called a prosthesis.

Your knee joint is made up of three bones: the femur (thigh bone), the tibia (shin bone), and the patella (kneecap). Over time, the cartilage between these bones can wear away, leading to pain, stiffness, and difficulty moving. During a knee replacement, the surgeon removes the damaged parts of your knee and replaces them with artificial components made from metal, plastic, or ceramic.

The aim of a total knee replacement is to restore your knee’s function, reduce pain, and improve your quality of life, allowing you to return to normal activities.

When is a knee replacement recommended?

The most common reason for a knee replacement is osteoarthritis, which causes the cartilage in your knee joint to wear down, resulting in painful bone-on-bone contact. Other conditions, such as rheumatoid arthritis, post-traumatic arthritis (after an injury), or knee deformities, can also damage the joint and require replacement.

If treatments like physiotherapy, pain relief medications, or lifestyle changes no longer help, your consultant may recommend knee replacement surgery. You might benefit from this procedure if you experience severe pain, difficulty walking, or problems with daily activities.

What to expect from the procedure

When you arrive at the hospital, you will meet your nurse, anaesthetist, and surgeon. The surgery is usually done under a general or spinal anaesthetic. It typically takes 1 to 2 hours.

During the operation:

• The surgeon makes an incision at the front of your knee.
• The damaged cartilage and bone are removed.
• Artificial components are positioned to restore your knee’s alignment and function.

There are different types of knee replacement prostheses. Your surgeon will choose the most suitable one based on your age, weight, activity level, and the extent of the damage. If only one part of your knee is affected, your surgeon may recommend a partial knee replacement instead of a total knee replacement.

You will usually stay in the hospital for 3 to 5 days, depending on how quickly you recover.

What are the potential risks and complications of knee replacement surgery?

As with any surgery, there are risks associated with total knee replacement. These may include:

• Infection at the surgical site
• Blood clots
• Stiffness in the joint
• Loosening of the prosthesis over time
• Persistent pain or limited mobility (in rare cases)

To reduce the risk of complications, you will usually be given blood-thinning medication to help prevent blood clots. Strict measures are also taken to keep the surgical area sterile and avoid infection. Regular follow-up appointments will help monitor the new joint and address any potential problems early.

Recovery after total knee replacement

Recovering from total knee replacement surgery takes time, usually 6 to 12 weeks. Physiotherapy is a key part of your recovery, helping you regain strength, flexibility, and mobility.

Here’s what to expect:

• You will start physiotherapy exercises soon after the surgery, often on the same day or the day after.
• Walking aids, like crutches or a walking frame, are often needed for the first few weeks.
• Following your physiotherapist’s exercise plan is essential for the best results.

Most people can return to light activities within 6 weeks, but full recovery can take up to 3 months or longer, depending on your overall health and circumstances. You should discuss returning to driving, work, and exercise with your surgeon to ensure a safe recovery.

Long-term results

Total knee replacement has a high success rate. Most people experience significant pain relief and improved mobility. The artificial knee joint typically lasts 15 to 20 years, though this can vary depending on your activity levels and the quality of the implant.

After recovery, you’ll be able to resume most daily activities. However, it’s best to avoid high-impact activities like running or heavy lifting to protect your new joint. Low-impact activities, such as walking, swimming, or cycling, are generally safe and encouraged to maintain joint health.