Knee replacement surgery: what you need to know
Written in association with:A knee replacement removes damaged bone and cartilage and replaces them with a metal and polyethylene prosthesis to restore functionality in the knee. In this article, Mr Stephen Veitch, a consultant orthopaedic surgeon, explains the reasons and process of a knee replacement surgery.
Understanding the knees
The knee is the body’s largest joint, at the junction of the thigh bone (femur) and the tibia (shin bone), and topped by the kneecap (patella). Surrounding it are an assortment of muscles, ligaments, and cartilage (such as the meniscus).
The knees are a fundamental structure for human movement. They enable walking, sitting, crouching, dancing, jumping, cycling… knees are used constantly in daily life. They support a lot of the body’s weight, and help maintain balance. So, when something goes awry, it can be quite debilitating.
Knee replacement is major surgery, so it is considered the last option for people who are suffering from debilitating and chronic knee pain, who are less mobile due to knee issues, or who have had an accident that has resulted in the sudden and complete destruction of the knee.
What are the reasons for knee replacement surgery?
The main reasons a knee might need replacement are:
- Arthritis, which is when the joint becomes inflamed due to a loss of the articular cartilage. Common kinds of arthritis are osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis.
- Fractures or major ligament disruption, which can happen during accidents and lead to post traumatic arthritis
- Previous joint infection leading to a loss of articular cartilage.
Patients of knee replacements tend to be between 60 – 80 years old. They last an average of 25 years, so it is unlikely that a patient will need more than one replacement in their lifetime, but it is better to get one later rather than sooner so that it will last longer.
What does knee replacement surgery consist of?
There are two kinds of knee replacement surgery:
- Total, which is the majority of knee replacement surgeries, and involves the lower end of the femur and the upper end of the tibia being removed and replaced with metal and plastic.
- Partial, which is used for cases where the damage, such as arthritis, is only on one part of the knee that is then replaced.
A knee replacement is performed with a spinal or general anaesthetic and takes around one hour. The procedure starts with the surgeon making an incision down the front of the knee and moving the kneecap away so that the joint can be accessed. The damaged bone is sawn off and shaped so that the new replacement can be fitted on top. The kneecap is then put back into place and the incision is sealed and dressed.
What happens after a knee replacement?
Recovery from knee replacement can take several months, perhaps up to a year, but this varies based on the kind of knee replacement and the condition of the patient. After the surgery, the patient will be prescribed painkillers. A patient will likely spend one night in the hospital to recover before returning home but a number of units are now offering day case surgery. Patients will need to undergo physiotherapy in order to learn how to use the new knee and strengthen the muscles.
If you are considering a knee replacement, consult with Mr Veitch today via his Top Doctors profile.
