KNEE REPLACEMENT

What is a Knee Replacement

A knee replacement involves the removal of damaged arthritic bone at the ends of each of the femur and tibia and replacing both of these areas with a special metal material. In between both of the metals a special plastic is placed to help the new prosthesis to function optimally. 

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Stiffness and knee pain are common symptoms that can result in the requirement for surgical intervention but not before conservative options have been exhausted. These symptoms are often as the result of degenerative joint disease such as osteoarthritis.

Joint disease can significantly impair a person’s quality of life. Although knee replacement surgery is generally a last resort, it is a very successful treatment option to help reduce pain levels whilst also helping to restore function.  

FAQs​

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Am I a candidate for a total knee replacement?

Those patients with significant joint disease like osteoarthritis that haven’t responded to non-invasive treatment options such as physiotherapy may need a knee replacement. Each patient is different and this is why a consultation is necessary to discuss the most appropriate options for you.

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What should I expect during a total knee replacement?

Knee replacement surgery will require a short period in hospital. Anaesthesia will be required and an incision will be made to expose the bone beneath.

Damaged cartilage will be removed and the affected arthritic areas will be replaced with metal prosthesis. The entire procedure is relatively quick and will usually takes no more than 1 or 2 hours.

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What should I expect after surgery?

Post-operative care is vital to successful surgery. The medical staff such as doctors and nurses will monitor your progress and care for you as needed.

You will be required to partake in a rehabilitation programme as research shows that your participation here will have a large bearing on the successful outcome of your knee replacement. All of this will be overseen by your surgeon.

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How long is the operation?

The operation is approximately 2 hours.

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What are the components made of?

Knee replacements consist of a few different parts. Both the femoral and tibial components are made from a cobalt chrome alloy. In between both of these parts is a special plastic. This is made from polyethylene which is annealed, highly cross linked and gamma irradiated to optimise its wear properties.  Should the patella need to be resurfaced a button like plastic is inserted. This is again made from highly cross-linked polyethylene.

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Will I have to get my knee replaced again once it “wears out?”

The technology behind knee replacements in terms of the components used have helped to significantly improve the longevity of knee prosthesis. Whether or not your knee will needed to be replaced is multifactorial and although some people may to have “revision” surgery the numbers are small. 

How long should I use pain medication?

This is different for each patient. Pain will be present after the operation but can be lessened with medications such as paracetamol and anti-inflammatories.

During your hospital stay nursing staff will be present to monitor this. A general rule is that you should try to decrease your use of these medications as time passes.

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How long will I be at the hospital?

Most patients stay in the hospital one to two nights and are then discharged. Each patient must meet medical criteria for discharge as well as meet certain physiotherapy criteria.

If you require more therapy or medical management we will delay discharge until those needs are addressed.

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When can I shower?

You will be advised by the nursing staff as to how soon you can shower when you are in the hospital. Waterproof dressing are used on all incisions to ensure that the surgical site remains clean and dry.

You should avoid however getting too much water onto the dressing. After the dressing is removed at approximately one to two weeks you can shower normally with the incision exposed. Be sure to pat the skin over the incision and avoid rubbing it with a towel.

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When can I drive?

This is very much dependent upon each individual. A good indicator is when you are able to sit, rise and rest comfortably in a chair. Being able to lift your leg from side to side is also a good test. Remember though that driving will require a significant amount of bending at your knee and a prolonged period of time in a car may cause pain. This will lessen over time but we advise caution with regard to this.

I am experiencing a lot of swelling, is this normal?

Due to the effect of gravity fluid can accumulate in the legs. It is common that this wasn’t present in the hospital but now is present when you return home. This is generally because you are being more active at home.

In order to address this you should elevate your legs at night by lying on your back and placing pillows under the legs so that they are above your heart.

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Compression stockings can be worn during the day to help. Maybe someone at home can help you put these on in the morning, use them during the day and then take them off at night. These can be purchased from most pharmacies if needed.

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When can I return to work?

This is determined by your occupation. Your recovery period is important and a time off work will enable you to concentrate on your rehabilitation programme. It is good advice to take time off during the initial post-operative period.