Total knee replacement surgery can be performed in painful arthritic knees that are no longer helped with non-surgical treatments. Total knee replacement is carried out to treat arthritis in any area of the joint, especially if more than one area of the knee is arthritic. The surgery removes the surface of the joint and replaces it with metal and plastic. In some circumstances the back part of the patella may also be resurfaced with plastic.
You will be admitted on the same day as your operation.
The surgery is usually performed using a regional (spinal) anaesthetic with sedation or a general anaesthetic. The procedure usually takes 1-2 hours.
The knee implants are securely fixed in place and bending the knee should start immediately after the surgery. Normally you will be up walking on your knee the same day as your surgery with the help of a physiotherapist. The knee is often far more sore the day after the surgery and you will be given regular pain killers to help with this. It is important to ice the knee frequently to help reduce the swelling and keep it elevated when you are not up and around.
Usually you will be ready to go home three days after your surgery, however this varies. Once home it is vital that you continue taking regular pain killers, icing and your exercise regimen as this helps to improve the range of movement and reduce swelling.
Following any form of knee replacement it is normal for the knee to continue to be uncomfortable, swollen and warm for three months after surgery. From this time the swelling gradually subsides. It usually takes 12-18 months for all the improvement to be felt in the knee following a total replacement.
The amount of movement (bending) that can be achieved following knee replacement surgery is largely determined by how well the joint moved prior to surgery. This is one of the reasons why it is important to perform stretching and strengthening exercises both before and after surgery.
Total and partial knee replacements are made from metal and plastic. It is not unusual to experience clicking sensations or sounds originating from knee and this is usually nothing to be concerned about and is a result of the metal and plastic bearings knocking together. Many patients also describe an intermittent ache, usually on the inside of the knee that tends to be worse in the cold, wet weather. This usually improves over time and settles with mild pain killers.
Total knee replacement surgery is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
These are the unwanted, but mostly temporary effects of a successful treatment, for example feeling sick as a result of the anaesthetic.
Your knee will feel sore and stiff and may be swollen for up to six months.
You will have a scar over the front of the knee. You may not have any feeling in the skin around your scar. This can be permanent, but could improve over one to two years. The scar may be uncomfortable to kneel on.
This is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (DVT) or rarely in the lung (pulmonary embolism).
Specific complications of knee replacement are uncommon, but can include:
The artificial knee joint usually lasts for well over 10 years. Over time it may begin to wear out or become loose, like any other mechanical device, after which you may need to have it replaced.
The exact risks are specific to you and will differ for every person. Your surgeon will discuss risks with you and be happy to answer any questions or concerns you may have.
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