If you’re considering knee surgery, you likely have questions and concerns. To help ease your mind, we spoke with Mr. Anthony Gibbon, a Consultant Specialist Knee Surgeon at Clifton Park Hospital in York, who has over 25 years of experience. He shares what you can expect before and after your procedure.
Q: When should someone consider seeing a consultant for osteoarthritic knee pain?
When I receive this question from my patients, I ask them to consider the following:
· Is the pain impacting your lifestyle and preventing you from doing things you should be able to?
· Is the treatment you have already no longer effective?
· Are you ‘fed up’ with your knee?
If the answer is YES then it is time to seek advice.
Q: What happens during a consultation?
Initially, we have a detailed discussion about your symptoms. I ask about how and when the pain started, how far you can walk comfortably, and how the pain affects your daily life. A physical examination follows, along with an X-ray of the knee. In most cases a treatment plan is clarified at the point, be it comprising physiotherapy, bracing, pain-relieving injections or surgical intervention. Occasionally, further imaging such as an MRI, CT or bone scan may be undertaken. All such plans will be carefully discussed with you giving you ample opportunity to ask questions.
Q: What surgical options are available?
Arthroscopy of key-hole surgery rarely has a useful role in treatment of established knee arthritis. It does, however, have widespread benefits for many other knee disorders and is usually carried out as a day case, under general anaesthetic, with rapid return to full function.
Whilst there are some surgical alternatives to total or partial knee replacement for arthritis, mainly in younger patients, most patients with disabling symptoms who have failed to benefit from non-operative measures elect to undergo knee replacement surgery. Up to a third of patients undergoing knee replacement surgery benefit from a partial knee replacement, resurfacing just the affected area of the joint. This is less invasive, less traumatic and allows a quicker recovery. Most of such patients go home the same day.
Q: What can patients expect on the day of surgery?
On the day of your surgery, you'll arrive at Clifton Park Hospital a couple of hours beforehand. Here’s how the day will typically unfold:
- Arrival and Check-In: After checking in, you’ll be greeted by the nursing team, who will take you to your room and make sure you’re comfortable. They’ll review your medical history and answer any questions you might have.
- Meet the Team: You’ll meet key members of your surgical team, including the physiotherapist, surgeon, and anaesthetist. This is a good time to ask any last-minute questions about the procedure.
- Consent and Preparation: We will confirm your consent for surgery, ensuring you fully understand what’s going to happen. Your knee will be marked with an arrow, so everyone knows exactly which one we’ll be operating on. You will be escorted to the operating department and met by the anaesthetic team.
- Anaesthesia: Most patients receive spinal anaesthesia, which completely numbs the lower body. This is typically administered via a small needle while you sit up on the table. You’ll be closely monitored throughout this process. Once the anaesthesia takes effect, you’ll lie down and receive sedative medication to help you relax. As a result of the sedation most patients are asleep throughout the operation. Some patients choose to be awake during the spinal anaesthetic, others preferring a General Anaesthetic. Whichever method is used the team will ensure that you are safe and comfortable and have as much or as little awareness of what is taking place as you choose.
- Surgery: Once you're comfortable, you’ll be moved into the operating room. The surgery itself usually lasts around 45 minutes. During this time, you’ll be in a sterile environment with a skilled team focused on your care.
- Post-Surgery Recovery: After the surgery, you’ll be taken on your bed to the recovery area. You’ll wake up comfortably, and nurses will monitor you closely for a short time until you are ready to return to your room.
- Initial Mobility: Once in your room we’ll help you start moving your legs. You will be encouraged to sit up in bed, eat, and drink as soon as you are able. A cooling cuff is applied to the knee for comfort. Patients are able to walk on the day of surgery with minimal assistance.
- Pain Management: Pain relief and anti-nausea medications will be provided to ensure you’re comfortable. Early movement is key to rapid recovery.
Q: How long will I stay in the hospital?
Most patients are comfortable and safe enough to leave Clifton Park Hospital within 24-36 hours after a total knee replacement. Most having partial replacements go home within 24 hours., most on the day of the operation. Before going home, patients are able to move around independently and manage their own personal needs.
Q: When can I start daily activities again, such as driving or exercise?
Typically, patients can return to driving in about 3-4 weeks, depending on their comfort level.
Whilst surgeons don’t encourage lots of high impact activity, such as long-distance running, most knee replacement patients should ultimately be able to get back to swimming, hiking, biking and going to the gym without difficultly.
Over the years, I have loved receiving videos and pictures from my knee placement patients of them climbing Mount Snowdon, hiking the Inca trail and even skiing. It’s a humbling privilege to be able to restore such pleasurable function to my patients.
Q: What’s your final message to patients considering knee surgery?
While a small percentage may feel the surgery hasn’t met their expectations, most patients express they wish they had undergone it sooner. The goal is to restore function and alleviate pain, allowing patients to enjoy life to the fullest once again.
Read more from Mr. Gibbon on his consultant profile here and listen to a podcast he recorded recently, which covers more key themes here.
