Knee Replacement

Knee replacement surgery, (knee arthroplasty), replaces damaged, worn or diseased cartilage and bone in your knee joint with a prosthetic joint made of metal, ceramic or plastic. It aims to reduce your pain and allow your joint to move in the same way as a natural joint so as to improve your mobility.

There are two main types of knee replacement:

• Total knee replacement (TKR) surgery – the whole of your existing knee joint is replaced.

• Partial knee replacement (PKR) – also called unicompartmental or half-knee replacement as only one side of your knee is replaced, used when knee arthritis is confined to one compartment of your knee.

Your knee surgeon will discuss the best surgery for your knee anatomy needs.

Most people have the procedure under general anaesthetic. Your surgeon will make a cut down the front of your knee and move your kneecap to one side to reach your joint. 

They will remove worn or damaged surfaces from the end of your thigh bone and the top of your shin bone and shape them to fit your artificial knee joint. Cement may be used to bond the new joint to your bones. Once the new joint is in place they will close your incision.

Knee replacement surgery is often recommended if you have:

• arthritis or an injured knee joint that is severely painful and, impairing your mobility, ability to do everyday tasks and your quality of life and sleep

• tried non-surgical treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy and steroid injections and, they haven't relieved your pain and helped your movement.

Initially, you might visit your GP if you are experiencing persistent pain in your knee or you are finding it difficult to do normal things because of stiffness or loss of mobility. They may carry out a physical examination, and order X rays and blood tests to diagnose the underlying problem. Your GP may recommend non-surgical treatment options or refer you to a consultant orthopaedic surgeon to discuss other options including a knee replacement operation. If you are overweight, you may be asked to lose weight as this will reduce the strain on your knee.

The usual reason for a knee replacement is arthritis, with the most common type being osteoarthritis. This is the gradual wear and tear of your knee joint that results in damage to your cartilage covering the surface of your joint and the bone underneath and is very painful. 

It is extremely important that you keep your knees healthy to prolong a knee replacement, there may come a time when knee replacement surgery might be something you have to consider, but in the meantime there are things you can do to keep your knees moving to reduce the risk, read more here.

An operation can take up to two hours depending on the type of replacement surgery.

You can expect your knee replacement to last at least ten years and up to twenty years. Most people enjoy less pain and better mobility following their knee replacement.

The length of time you are out of work following a knee replacement is dependent on your individual circumstances including: your health, how you respond to knee surgery, how you heal and, the type of job you do. 

If you have a desk job, you may return to work around six to eight weeks after your knee replacement. If your job is more physically demanding and involves a lot of heavy lifting, standing up or walking for long periods of time you may need to take up to 12 weeks off work after knee surgery. 

When considering your return to work you will also need to think about your ability to get to and from work and, the amount of painkiller you are taking as this can cause drowsiness.
It may be that you agree a phased return to work with your employer.

Getting back to your normal work routine sooner rather than later can help you to recover more quickly. Too much time may be detrimental to your health as you could become isolated and depressed.

The time it takes to walk after a procedure can vary from person to person. 

You will be encouraged to stand and walk whilst you are in hospital. 

Most people are able to walk on their own using crutches or sticks about a week after their procedure. These walking aids support you whilst your muscles are weak and help prevent falls that could damage your joint.

You will gradually build up your strength in your knee after a knee replacement by keeping active and doing the exercises advised by your physiotherapist.

Six weeks after your knee surgery, you should be able to stop using walking aids and resume your normal leisure activities.

You should not kneel on your operated knee until your surgeon gives you the green light to do so. This is usually around three months after your knee surgery when the scar tissue has healed enough.

Many people can kneel without any discomfort once they have fully recovered from a knee replacement but others may find it uncomfortable to do so. As time passes you should find it easier to kneel. Using a pillow, a cushion or knee pads can make kneeling more comfortable.

Some people avoid kneeling after their surgery as they have the misconception or uncertainty that it may be harmful to their knee following knee surgery. You should talk through any worries you have about your knee replacement in detail with your knee surgeon.

At Ramsay, we are very conscious that a speedy recovery is important after the procedure. Aftercare is a valuable part of our care and we aim to get you back to normal life, as soon as possible.

You will typically stay in hospital with us for two days or less. One of our physiotherapists will explain and demonstrate exercises to do at home to help strengthen your knee and they will offer advice about everyday living and what you should and shouldn’t do. Initially you’ll be given crutches or a frame to help you walk. Physiotherapy is often advised for a number of weeks after knee replacement.

In the immediate period following your return from hospital, you may need help in the house and with your usual activities. Gradually, you will be able to move around more and start driving and doing housework, and return to work. You may need painkillers for this initial period.

We will offer you a follow up appointment with your consultant to check on your progress.

Your knee replacement recovery is individual to you. It can take up to 12 weeks for pain and swelling to go down, but many patients will recover quicker than this. You should follow your knee surgeon’s post-operative advice. 

Our staff will be able to answer any questions you have about your recovery and what you can expect over the weeks after your operation.

Before your total knee replacement, you will be given an anaesthetic to prevent you from feeling pain during the surgery. This may be a general anaesthetic that puts you into a deep sleep, spinal anaesthetic, or an epidural when you are awake but takes away any feeling from the waist down.

After total knee replacement surgery, you can expect pain, swelling and bruising as part of the natural recovery process. Every patient is different but you can expect it to take up to three months for the pain and swelling to settle down.

Knee replacement is the most common joint replacement procedure. However, it is a major operation and is normally only recommended if other conservative treatments, such as physiotherapy or steroid injections, have not worked in reducing your pain and improving your mobility.

When you leave hospital after your surgery you can stay home alone, but you should prepare your home before going into hospital for your surgery.

You should have a bedroom set up with easy access to a bathroom and kitchen so that you can navigate your way around easily, and place items you will need and use regularly at table-top height so you do not have to reach up or bend down. Make sure you have the food provisions you need.

You may want to arrange for someone to help you for the first week or two. You may feel very tired at first, and your muscles and tissues around your knee replacement will take time to heal.

Make sure you follow your surgeon or your care team’s post-operative advice and call us or your GP if you are worried about anything.

You should take extra care in the first few weeks after your knee replacement and avoid some movements, such as twisting at your knee and crossing your legs, to prevent injury. You should also avoid slippery floors without non-slip socks or shoes, sitting on sofas or chairs that you sink into and getting up at night without a night light on.

Once you have recovered from your procedure surgery you can return to your normal daily activities and certain more vigorous physical activities. You may be advised to avoid some high-impact sports or aerobics that involve jumping, twisting, jerking, pulling or running as these movements may compromise your new knee.

Your surgeon or physiotherapist will advise you specifically on what to avoid in the first few weeks after your knee surgery and beyond.

Mr Marcus Cope, Consultant Orthopaedic Surgeon answers some additional questions around what you can do after knee replacement surgery here. 

If you decide to pay for your treatment, Ramsay offer an all-inclusive Total Care package, where a single one-off payment at a pre-agreed price, delivering direct access to all the treatment you need for complete reassurance. You can also spread the cost of your treatment with finance options available. The knee replacement (knee arthroplasty) cost depends on your local Ramsay facility, to find out more information around knee replacement surgery cost click here.

The procedure may be covered by your medical insurance policy. We advise you to check directly with your insurance provider and get written confirmation before commencing treatment.

One of the major advantages of seeing a knee surgeon privately is that your appointments and treatment are arranged at times to suit you and without any unnecessary waiting. This is especially important if you are in a lot of pain or if you want to avoid particular dates for surgery.

You will be treated by an experienced orthopaedic surgeon with a special interest in knee surgery who will be able to discuss your individual needs and select the best prosthesis for you.

Additional benefits of being a Ramsay Private patient include:

• choice of consultant, where possible
• rapid access to expert opinion on the best treatment for you
• fast track admission and discharge
• single bedded rooms with en suite bathroom and flat screen TV
• choice from our a la carte menu as an inpatient