Mr Matthew Gee MBBS, BSC, MSC, FRCS (Tr&Orth) Consultant Orthopaedic Surgeon

Total Knee Replacement

Total knee replacement is a procedure in which the entire knee joint is replaced with an artificial knee. Most people who have this operation are over 60, but it is also becoming more common in younger patients.

Who Should Consider Total Knee Replacement?

Knee replacement surgery may be recommended if your knee joint has become worn or damaged. Knee replacements are often performed because of conditions such as osteoarthritis or another degenerative disease. You might also need to have a total knee replacement after an injury. The surgery can be a good idea if you are in pain or if your mobility as limited. However, knee replacement surgery is a major operation so it is important to consider other treatment options first including weight loss, painkillers and exercise to make the muscles around the knee strong.

The Procedure

Total knee replacement surgery is usually performed under a general anaesthetic, so you won’t be aware of anything that is happening during the procedure. Sometimes an epidural is used instead, which means you will be awake but unable to feel anything below your waist. The surgeon will make an incision at the front of the knee and move the kneecap out of the way. The ends of the thigh and shin bones will then be removed so that the knee implants can be fitted on either side of the joint. The back of the knee cap may also be replaced. The surgical incision will then be stitched up and you will be taken to the recovery ward to wake up. Your doctor will usually encourage you to start moving as soon as it is safe to do so. You will work with a physiotherapist to improve the movement and strength in the knee and may need to use crutches or a walking stick for up to six weeks after the operation. It can take up to two years for the knee to recover completely and be as good as it can be. The more work and effort you can put in the better the outcome will be.

Risks and Benefits

Knee replacement surgery can make a big difference to your mobility and quality of life, but it is important to be aware that there are both risks and benefits to the procedure:

  • Surgery always carries a small risk of complications such as heavy bleeding, infection, damage to the nearby nerves, and blood clots. Your doctor will make sure that you understand these before you have the operation.
  • The knee implant should last for about 20 years in most patients, but it may need to be replaced at some point, which will require another operation.
  • Having a total knee replacement should help to relieve any pain in the joint and improve your mobility, although it could take some time to recover completely after the procedure. Despite a perfect operation some patients (20-25%) may have some ongoing discomfort but it is usually less than prior to the operation and mobility is much improved.

If you are suffering from knee pain or reduced mobility, you should make an appointment to discuss total knee replacement with an experienced orthopaedic surgeon.

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