When your knee joint is damaged to the extent that your mobility is reduced and you are experiencing pain even at rest, this could be due to arthritis or injury to the knee. Most of the knee replacements are carried out between the ages of 60 to 80 years but adults of any age can be considered for the surgery depending on their symptoms.

Other conditions which may cause knee damage are:

-rheumatoid arthritis

-haemophilia 

-gout

-bone dysplasia (unusual bone growth)

-Avascular necrosis (bone death due to loss of blood supply)

-knee deformity with pain due to loss of cartilage.

Surgery is recommended when all other modalities of treatment such as physiotherapy and steroid injections fail to provide pain relief and improve mobility. If the knee pain is having an impact on your daily activities of living such as walking, getting out of a chair/bed, climbing stairs and you cant work or have a social life, you need consider having a knee replacement.

Types of knee replacement surgery

There are two main types of knee replacements:

1. Total knee replacement(TKR) – this type of surgery is performed if both the inner and outer half of the knee are worn out and therefore both sides are replaced ie a Total knee replacement.
2. Partial (half) knee replacement(PKR)- this type of surgery is done if only one half of the joint is affected. It is a smaller operation, quicker recovery and shorter hospital stay.

What are the risks of surgery?

-Blood

-Infection

-Injury to nerve and blood vessels

-Fractures

-Stiffness and instability of the joint

-Need for additional surgeries

I addition patients who suffer with insulin dependent diabetes, malnourishment, hemophilia or those who have had previous joint infections are at increased risk of infection. Please make sure you get in touch with the hospital if you experience any of the above problems after the surgery.

Joint replacement has a life span of 15-20 years dependent on the activity level and life style of the patients. Knee revision may be needed if in future the artificial joint becomes painful. You can get more information by reading Knee Revision surgery.   

Several factors determine the success of knee replacement surgery. These include bone quality, muscles and general fitness of the patient and lifestyle. A major contributor to a successful joint replacement is commitment to physiotherapy and rehabilitation effort by the patient.

 How do I prepare for the surgery?

In order to achieve a good outcome following surgery you should stay as mobile as possible to maintain your muscle strength, as this will help you to rehabilitate quicker after surgery. You will need to attend a pre-assessment clinic to get your blood test done and a health check to determine your fitness for the surgery. Depending on the patient’s condition additional tests may be required prior to the surgery.

Please inform the nurse about any medication you are taking and any preexisting medical conditions.

Anesthesia 

One of my colleagues from the Warwick anesthetic group will meet you before surgery. They will explain the different types of anesthesia available and the risks and benefits of the surgery. The spinal or epidural anesthetic is the most common and safe anesthetic used for orthopaedic procedures. 

Physiotherapy

After surgery you will be seen by the physiotherapist who will help you with your rehabilitation, teach you exercises to improve your mobility and strengthen your muscles. I recommend using an exercise bike both before and after your surgery to improve motion in the knee and strengthen your muscles.