Knee replacements

Total (full) and Uni (half) knee replacements are performed at SWLEOC by leading UK surgeons.

treatment-consultation

A knee replacement is a surgical procedure to replace the worn out part of the knee joint.

It aims to improve patients quality of life and function who suffer with knee arthritis once simple measures such as pain killers have stopped working.

Why would I need a knee replacement?

1.
Over time, knees can be damaged by arthritis, fractures or because of abnormally shaped knees from birth

 

2.
Knee arthritis can make everyday life extremely distressing as walking, standing up and getting out of bed become difficult and painful.

3.
Your General Practitioner will help you address any weight issues, prescribe you medications and refer you for physiotherapy when your symptoms begin. When these measures no longer control your symptoms, hip replacement can be considered.

 

4.
When day to day tasks become difficult and there is pain in the knee when lying or sitting, knee surgery should be considered.

What happens during the procedure?

1. You will be fully assessed to check you are physically well enough for surgery.

This starts with the consultation with your surgeon in clinic, you will then attend a pre-assessment clinic where you are assessed by a specialist nurse and sometimes an anaesthetist if you have other medical problems. You may require some additional blood tests and investigations before your surgery. You will have a chance to ask questions about your anaesthetic and what happens before and after surgery.

What happens during the procedure?

2. A spinal anaesthetic and occasionally a general anaesthetic are used so you do not feel the surgery.

For the majority of patients a spinal anaesthetic is used for the surgery with medicine to make you sleepy. This is the preferred method to ensure you do not feel any pain during the surgery but still breathe for yourself which helps you to recover more quickly after the surgery. You will have a chance to discuss the anaesthetic before the surgery.

What happens during the procedure?

3. The old worn out knee joint is removed and a new artificial knee is inserted (speak to your surgeon about the implants and whether a full or half replacement is right for you).

The surgeon and their team will meticulously prepare the knee prior to surgery and apply sterile drapes over the knee. A torniquet is used in some cases. A careful incision is made in the skin and the knee joint is exposed. The old worn out knee joint is removed and the bone ends are cleared of arthritis. A trial knee joint is inserted.

What happens during the procedure?

4. The joint is checked thoroughly for movement and stability. The muscles and tendons around the knee joint are repaired.

Once the trial knee joint is inserted the surgeon very carefully assesses the movement and stability of the new knee to check that it will function well for you before they fully insert the final knee. Once the final knee is inserted everything is cleaned and the muscles and tendons around the knee are repaired. Local anaesthetic is inserted in the deep tissues to give you good pain relief on the ward.

What happens during the procedure?

5. You return to the ward and are helped on to your feet by the physios often on the same day of surgery.

You will spend sometime in recovery after the operation. As soon as you are well enough you will be transferred to the ward. On the ward you will be seen by physios and nurses and as soon as possible you are encouraged to walk. You will have a check xray on the day of the surgery or the day after to confirm the position of the new knee and will return home after 1-3 nights stay when it is safe for you to do so.

Risks

All surgical procedures have risks associated with them, some of the specific ones are listed below. You will have a detailed discussion with your surgeon about:

  • Bleeding and blood clots which can be life threatening but are rare and we have measures in place to keep you safe
  • Infection which in SWLEOC is lower than the national average.
  • Knee stiffness and persistent pain after the procedure is common and physiotherapy is required after. It can take over a year to fully recover from a knee replacement
  • Need for further surgery or to have the surgery done again if the artificial knee fails or becomes infected

Recovery time

0-1 Day
Walk on day 0 with crutches but fully weight bearing. Discharge from hospital after 0-1 day, able to self care and mobilise without help from others

2 weeks

2 weeks gradually walking with less need for aids

6 weeks

Walking without crutches into clinic for review at 6 weeks

Information videos