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Having a total knee replacement

In today’s society having a knee replacement has become fairly common or routine, however it still remains a knee replacement is a major surgical procedure. It is important you feel fully informed about the procedure and your recovery, when considering ‘is the best treatment for me’?

A knee replacement is usually recommended by your Consultant when a significant amount of arthritis has damaged your knee. Diagnosis is usually confirmed following a consultation and confirmed by an X-ray or an MRI scan. It is usual to have tried other interventions such as Physiotherapy, Acupuncture or Steroid injections to manage you symptoms prior to this. An arthroscopy may have also been performed to assess the inside of the knee and try to clean and ‘repair’ some of the existing damage.

Sometimes when the arthritis is widespread, your surgeon may indicate replacement surgery to be more appropriate at this stage, as other interventions would be of little value.

Reasons to consider knee replacement

  • You have severe pain, swelling and stiffness in your knee joint
  • It has become difficult and more painful to walk.
  • Your knee pain wakes you at night
  • You cannot work or have a normal social life
  • Everyday activities such as climbing stairs, getting up from a chair, shopping or getting out of the bath, are difficult or impossible
  • Your quality of life is affected

What does the procedure involve?

Knee replacement surgery (arthroplasty) involves replacing a damaged, worn or diseased knee with an artificial joint. For most people, a replacement knee will last for at least 15 to 20 years.

Prior to your surgery, your consultant will have measured and calculated your joint size by looking at your X-rays, ensuring the best prosthesis (replacement) is chosen suiting the shape and size of your knee.

knee-XR-web

 

Xray images

There are two types of replacement surgery; your Consultant will consider which would be most appropriate. In some cases your Consultant may feel it only necessary to replace part of the knee. This is known as a Partial knee replacement.

Terminology

  • A partial knee replacement (PKR) involves replacing only one side of your joint. This is typically the inner side your knee (medial). The procedure requires a slightly shorter stay in hospital, usually 3 days.
  • A total knee replacement (TKR) involves replacing both sides of your knee joint. The procedure usually requires a slightly longer stay of up to 5 days, however you should be able to walk a short distance the next day with your Physiotherapist and a pair of crutches.

What can I expect?

It is important when considering surgery, to understand what the procedure can and cannot achieve. Having a realistic expectation is key to a good recovery.

A knee replacement will offer long-term pain relief; the difficulties you faced with everyday tasks such as climbing stairs, walking or playing sport will be significantly improved. However this all takes time. It is important to remember a total knee replacement will not allow you to do more than you could before you developed arthritis.

It is normal to expect some discomfort after your surgery, but this can be managed by pain control. Your hospital and anaesthetist will discuss this with you. Physiotherapy plays a key role in supporting your recovery. They will help you restore knee movement, regain strength and co-ordination, restore your walking confidence and help get you back to hobbies and sports.

It is important to recognise this all takes time; 12 weeks is a typical recovery period, but this can vary with every individual. Don’t worry if you are not progressing as you had expected, or like your neighbour who had there replacement done eighteen months ago! Your body will heal at its own speed and every person is unique. Supporting your recovery with pain relief and gentle exercise will help encourage strong, flexible muscle and tissues to develop during the healing phase.