TOTAL KNEE REPLACEMENT

Restore your quality of life

What is a Knee Replacement?

Knee replacement is knee surgery to repair worn arthritic knee joints or knee injuries using an artificial knee joint to help reduce pain and restore movement in your knee.

Knee replacement surgery, also known as knee arthroplasty, replaces damaged, worn or diseased cartilage and bone in your knee joint with an artificial joint made of metal and plastic. It aims to reduce your pain and allow your joint to move in the same way as a natural joint so as to improve your mobility.

There are two main types of knee replacement:
• Total knee replacement (TKR) surgery – the whole of your existing knee joint is replaced.
• Partial knee replacement (PKR) – also called unicompartmental or half-knee replacement as only one side of your knee is replaced, used when knee arthritis is confined to one compartment of your knee.

Mr Webb will discuss the best knee replacement surgery for you and your knee anatomy needs. There are pros and cons of each type of surgery. Most people have knee replacement surgery under spinal anaesthetic with sedation.

Mr Webb will make a cut down the front of your knee and move your kneecap to one side to reach your joint. He will remove worn or damaged surfaces from the end of your thigh bone and the top of your shin bone and shape them to fit your artificial knee joint. Cement is used to bond the new joint to your bones. Once the new joint is in place he will close your incision.

knee-arthroscopy

What conditions may lead to needing a Knee Replacement?

The usual reason for a Knee Replacement is Arthritis, with the most common type being Osteoarthritis. This is the gradual wear and tear of your knee joint that results in damage to your cartilage covering the surface of your joint and the bone underneath and is very painful. Other causes include Rheumatoid Arthritis, previous trauma or previous knee cartilage problems.

Robotic Arm Assisted Knee Replacement

Mr Webb is pleased to be a pioneer in the north east of England of Robot Assisted Knee and Partial Knee Replacement. This offers precise personalised planning and surgery, with rapid recovery and return to function. Click here for more details about Robot Assisted Knee and Hip Replacement Surgery

Who might need a Knee Replacement?

Knee replacement surgery is often recommended if you have:

• arthritis or an injured knee joint that is severely painful and, impairing your mobility, ability to do everyday tasks and your quality of life and sleep and
• tried non-surgical treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy and steroid injections and, they haven’t relieved your pain and helped your movement.

Initially, you might visit your GP if you are experiencing persistent pain in your knee or you are finding it difficult to do normal things because of stiffness or loss of mobility. They may carry out a physical examination, and order X rays and blood tests to diagnose the underlying problem.

Your GP may recommend non-surgical treatment options or refer you Mr Webb to discuss other options including a knee replacement operation. If you are overweight, you may be asked to lose weight as this will reduce the strain on your knee.

Recovering from Knee Replacement Surgery

Most people who have a knee replacement by Mr Webb will stay one or two nights in hospital, with some going home the same day, but recovery times can vary.

Once you’re able to be discharged, your hospital will give you advice about looking after your knee at home. You’ll need to use a frame or crutches at first and a physiotherapist will teach you exercises to help strengthen your knee.

Most people can stop using walking aids around 4-6 weeks after surgery, and start driving after about 6 weeks, although some can return sooner. Full recovery can take up to 2 years as scar tissue heals and your muscles are restored by exercise.

Total Knee Replacement Frequently Asked Questions

1. What is a total knee replacement?

Knee replacement is a surgical procedure performed to remove the diseased or damaged parts of the knee joint and replace them with new artificial parts, called prosthesis. The aim of a knee replacement is usually to gain pain relief from a diseased arthritic knee, and as a result to improve a person’s quality of life.

2. Is a total knee replacement a common procedure?

Knee replacement is a very common procedure. In England and Wales there are approximately 160,000 total hip and knee replacement procedures performed each year. Approximately the same number of hip and knee joints are replaced.

Knee replacement technology and techniques have advanced significantly over the last few decades, and knee replacement is usually a successful technique to restore quality of life and offer pain relief.

3. What's involved in a total knee replacement?

A traditional knee replacement usually takes around 60 to 90 minutes to complete. It is usually carried out under a spinal anaesthetic, whereby you are numbed from the waist down. Most people prefer to receive some sedation as well. Alternatively, sometimes a general anaesthetic can be used.
Once you’ve been anaesthetised, Mr Webb will make an incision over the front of your knee to remove and replace the damaged knee joint with artificial parts.

The prosthesis is made of metal, with a very hard wearing plastic (polyethylene) between the 2 pieces of metal to act as an artificial cartilage.

The artificial joint components can be held in place by being:

• cemented – the prosthesis is secured to healthy bone using a special tough cement. This is by far the commonest technique used in the UK.

• uncemented – the surfaces of the implants are roughened or specially treated to encourage the existing healthy bone to grow onto them and hold them in place.

4. Who should have a knee replacement?

If you have knee joint damage or disease with persistent pain symptoms that interfere with your daily activities then you may be a candidate for hip replacement surgery.

Mr Webb will discuss the best options of pain relief for you and if you should consider a knee replacement.

5. What conditions may require knee replacement surgery?

Some common reasons why a knee joint can become damaged include:

• osteoarthritis – known as “wear and tear arthritis”. The cartilage (a tough, flexible tissue that acts as a shock absorber and mould) inside a hip joint becomes worn away and causes the bones to rub against each other. Osteoarthritis is the most common cause of this type of damage. People who have had their knee cartilage (meniscus) removed or damaged in the past can go on to develop knee osteoarthritis

• rheumatoid arthritis- caused by the immune system. The body mistakenly attacks the lining of the joint whilst trying to defend the body against infection resulting in pain,stiffness and swelling

• hip fracture – a fall or similar accident can severely damage the knee joint so that a replacement is required.

6. What are the benefits of a total knee replacement surgery?

Knee replacement surgery aims to increase your mobility and improve the function of your hip joint to relieve pain and ultimately improve the quality of your life. Many people find that their life is transformed as they regain their mobility and independence without the pain they suffered before their knee replacement.

7. What are the complications that may occur?

The risk of serious complications during and after knee replacement surgery is low, estimated to be less than 1 in a 100. These include blood clots (deep vein thrombosis and pulmonary embolism) and infection. The most common complication of a knee replacement is that something goes wrong with the joint, which can include:

• loosening of your joint – caused by your prosthesis becoming loose or either the tibial or femoral side

• wear and tear – particles can wear off your artificial joint surfaces and be absorbed by surrounding tissue and cause loosening of your joint.

Further complications of a knee replacement can include injuries to the blood vessels or nerves, a fracture , ongoing pain, or future revision surgery. These are only generalised and it is important that you discuss with Mr Webb your own individual risk profile and concerns before you decide on surgery

8. What are the alternatives to knee replacement?

There are some non-surgical options that can be effective in helping you to avoid or delay knee replacement surgery.

Pain killers, such as paracetamol and ibuprofen, can help control your pain. A walking stick can make walking easier. An exercise program can strengthen the muscles around the hip joint and help to reduce stiffness. A steroid injection into the hip joint can sometimes reduce pain and stiffness. However if your pain worsens and becomes unmanageable then hip replacement surgery may be the best option for you. It sis impoetant to discuss all the options before making a decision on the best way forward for you.

9. How long will my total knee replacement last?

An artificial hip joint is designed to last for at least 15 years. 95% of the knee replacements that Mr Webb uses are shown to last at least 10 years prior to needing redo surgery. However it could wear out or go wrong in some way before this time and then further surgery is required to repair or replace the joint, known as revision surgery. Other knee joints can last a lot longer than 15 years.

10. Am I too young for a knee replacement?

In the past knee replacement surgery would primarily be offered to people over 60 years of age as they are typically less active, putting less stress on the artificial knee, than younger people.

More recently, with new technology that has improved the artificial parts so that they withstand more stress and strain and last longer, hip replacement surgery has proved to be successful in younger people.

Now a person’s overall health and activity level are more important than age in predicting a hip replacement’s success. In general though the younger a person is, the greater the chances of them needing a redo knee replacement at some point in their life. Also in general, younger people will have higher expectations of what they want to do on a knee replacement so it is important to have a realistic discussion of what is and isn’t possible to do with a knee replacement.

11. How can I get prepared for a total knee replacement?

Before you go into hospital there are some things you can put in place to make your recovery easier you return home. These include:

• Arrange for help. You will need a lift to and from the hospital. It is also beneficial to have someone to help you around the house for a week or two after coming home from hospital.

• Place items you use or will need and want every day when you return home within arm’s reach. These might include the TV remote control, books, telephone, and medicine.

• Stock up on food supplies especially easy to prepare foods such as frozen ready meals and tinned soups.

12. What happens after total knee replacement surgery?

You should be able to go home after 1-3 days. You will need to use a walking aid such as crutches or walking sticks for a few weeks after your operation. Your surgeon or physiotherapist will advise you about exercises that will help you regain and improve the use of your new knee joint and allow you to return to normal activities as soon as possible.

Most people are able to resume their ordinary lifestyle within 2 to 3 months but it can take up to a year and a half before you make a full recovery and experience the full benefits of your new knee.

Getting back to your normal work routine sooner rather than later can actually help you to recover more quickly. In most cases it’s usually safe to return to light work or an office-based job within 6 weeks of the operation. If your job involves heavy duties, you may need to be off work for longer.