Knee replacement – also called arthroplasty – is a surgical procedure to replace a damaged, diseased or worn out knee joint with an artificial implant. It is most commonly used for patients with osteoarthritis, rheumatoid arthritis or gout, or people who have had a serious knee injury. Most patients having this type of surgery are over the age of 65.
It is normally only offered if you have severe knee pain, swelling and loss of movement in your knee that is affecting your day-to-day life.
Often, other less invasive treatments such as steroid injections and physiotherapy exercises, will have been tried beforehand but may no longer be effective at controlling the symptoms.
Types of knee surgery
There are around 70,000 knee replacements in England and Wales each year and the number is rising.
The Irish National Joint Registry, “conservatively estimate that at least 2,604 total knee arthroplasties are performed in Ireland each year”
Depending on the extent of the damage to your knee, you may be offered a total knee replacement, which involves replacing both sides of your knee, or a partial knee replacement, which involves replacing only one side of the knee. The latter has a shorter recovery time as it is a smaller operation, however, only one in four people with osteoarthritis are eligible for this type of surgery.
This is what to expect if you are having knee replacement surgery.
Prior to surgery it is a good idea to do your research and find out who you would like to perform the procedure.
Choose an orthopaedic surgeon who is experienced in knee replacement surgery and revision knee replacements, and who can share their results with you.
In the weeks and months before your surgery, stay as active as you can by doing gentle exercises like swimming or walking. This can help to strengthen the muscles around your knee, which will be important during your recovery.
As part of your mental preparations, find out about the procedure you are having so you know what to expect. Reading blogs like this is a great idea!
You may need to make some adjustments to your home, as you will be using a walking aid when you come out of hospital. Consider moving your bed downstairs and make sure that everything you will need is easily accessible. Cooking and freezing nutritious meals can be a good idea so you don’t have to worry about cooking when you come out of hospital.
You will need to arrange for someone to pick you up from the hospital and someone will need to stay with you for a week or two after surgery to care for you at home.
A week or two before the procedure you will have a pre-operative assessment which will take your medical history and carry out a range of tests to ensure you are fit enough for surgery. You will have an opportunity to talk through the procedure with your surgeon and ask any questions you may have.
Most knee replacements are performed under general anaesthetic, which means you will be asleep throughout. Some are performed using an epidural, which means you will be numb from the waist down.
The worn part of your knee joint will be removed and replaced with an artificial implant, which is measured to fit your anatomy. It may be made of metal, plastic or ceramic and may be fixed in place with special cement or treated to encourage your bone to fuse together with it.
If you are having a total knee replacement, both sides of your knee will be replaced. This can take between one and three hours. If you are having a partial knee replacement only the damaged section of your knee is replaced, which is a shorter operation. It uses a smaller incision and less bone is removed.
The wound is closed with stitches or clips and a dressing is applied. Sometimes a splint may be used to keep the knee immobile but normally you will be encouraged to move your knee as much as possible.
After surgery, you will be encouraged to get up on your feet as soon as possible, normally within a day. You may be given crutches, a walker or a cane to support you. Most people experience a major improvement in their movement and flexibility and a significant reduction in pain. You will be encouraged to exercise to strengthen your knee muscles and reduce the swelling. You may be given exercises to do by a physiotherapist.
Most knee replacements last between 15 and 20 years if cared for properly. Your surgeon will advise you on the best way to care for your knee joint after surgery.
If you are considering a knee replacement, Joseph Queally will explain every step and provide practical guidance to ensure you are fully prepared and taken care of from start to finish.