Knee joint replacement surgery
A knee joint replacement operation may be recommended for damage from knee osteoarthritis, other types of arthritis, or other conditions.
Knee joint replacement surgery is called arthroplasty, and is a common operation carried out by the NHS for people usually aged 60-80.
Worn ends of the bones are replaced - under general anaesthetic - with plastic and metal parts that are specially measured to fit.
An artificial knee joint should last up to 20 years before it too needs replacing.
Knee surgery will be done after a GP's referral to a specialist surgeon.
Is knee replacement surgery right for me?
A person may be considered a candidate for knee replacement surgery if:
- Other treatments haven't helped symptoms such as severe pain, swelling, stiffness and reduced mobility
- Quality of life or sleep is affected by pain
- Independence is affected, such as problems with everyday tasks like bathing or shopping
- Symptoms cause depression
- Symptoms affect work or daily life
- General health is good enough to cope with the operation, recovery and rehabilitation.
Types of knee replacement surgery
Before a knee replacement operation is considered, other options may be explored, including:
- Arthroscopic washout and debridement: A special instrument is used to get access to the knee so that small pieces of bone or cartilage are washed out.
- Osteotomy: The shin bone is realigned to relieve pressure on the knee.
- Mosaicplasty: Cartilage and bone parts from elsewhere in the body are used to patch and repair damaged knee surfaces.
If it is to go ahead, the type of knee replacement operation offered will depend on an assessment of how damaged the knee is. The risks and benefits will be discussed, and the options are:
- Total knee replacement (TKR), in which both sides of the knee joint are replaced with artificial parts
- Partial knee replacement (PKR), one side of the joint is replaced with an artificial part
- Kneecap replacement, on its own if this is the only damaged part, also known as patellofemoral replacement or patellofemoral joint arthroplasty.
The partial knee replacement operation has a quicker recovery time with less time in hospital.
Before and after a knee replacement operation
Specific instructions will be given by the consultant and surgical team before coming into hospital for the operation, such as not eating from a certain time before the procedure.
While you are on the waiting list for the procedure, doctors will usually recommend trying to keep as active as you can, which may include physiotherapy.
You'll need to pack for around 5 days in hospital, and make arrangements for getting there and home again afterwards.
Following the operation aftercare advice will be given, and walking aids loaned to you to protect the knee as it heals after the operation. These may be needed for 6 weeks or longer in some cases.
If you drive, typically driving can begin again after 8-12 weeks.
Exercises will be needed to strengthen the knee again.
Follow-up appointments will be made to check progress.
Risks of knee replacement surgery
Most knee replacement operations go well, but there is always a chance of problems with any surgery. Knee replacement operation complications include:
- Continuing pain
- Knee stiffness
- Wound infection, sometimes needing a further operation
- Bleeding in the knee joint
- Damage to ligaments, arteries or nerves near the knee
- Blood clots
- Deep vein thrombosis (DVT)
- Broken bones during or after the operation
- Unstable joint needing further surgery
- Manufacturing problems with artificial knee components, updates can be received by joining the National Joint Registry.
Seek medical advice after any operation if you have increased pain, bleeding, fever or other concerns.