Knee replacement

 

 

1. What is knee replacement surgery?

Knee replacement surgery involves replacing a damaged or worn-out knee joint with an artificial one. This procedure is typically recommended for individuals suffering from severe knee pain or dysfunction due to conditions like osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis. There are different types of knee replacement surgeries, each designed to address specific knee joint issues.

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2. What are the different types of knee replacement surgery?

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• Total Knee Replacement (TKR): This is the most common type of knee replacement surgery. It involves replacing the entire knee joint with an artificial prosthesis, including the femoral (thigh) component, tibial (shin) component, and the patella (knee cap) component. This option is typically recommended when the entire knee joint is damaged by arthritis or injury.

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• Unicompartmental Knee Replacement (UKR): Unicompartmental knee replacement involves replacing only one part of the knee joint—either the medial (inside), lateral (outside), or patellofemoral (front) compartment—while leaving the rest of the knee joint intact. This is ideal for patients with isolated arthritis in a single compartment of the knee, typically younger, more active individuals, as it allows for quicker recovery and better preservation of knee function.​

 

3. When is knee replacement surgery recommended?

Knee replacement is typically recommended when conservative treatments, such as physical therapy, medications, injections, or lifestyle modifications, no longer relieve symptoms. Patients who experience persistent knee pain, significant loss of function, difficulty walking, or trouble performing daily activities (e.g., climbing stairs, getting in and out of a car) may be candidates for knee replacement surgery.

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4. How do I know which type of knee replacement is right for me?

The type of knee replacement surgery that is best for you depends on the extent of joint damage, the location of the arthritis, and your overall health.

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• For patients with arthritis in only one part of the knee, unicompartmental knee replacement may be an option.

• For those with widespread arthritis or significant damage to the entire knee joint, total knee replacement is typically recommended.

• Patellofemoral replacement is generally reserved for individuals with damage to the kneecap joint alone.
   

Your surgeon will perform a thorough evaluation and recommend the most appropriate surgery based on imaging studies (X-rays, MRI) and your symptoms.

 

5. What is revision knee replacement surgery?

Revision knee replacement is a procedure performed when a previously implanted knee prosthesis fails. This can happen due to reasons like wear and tear, loosening of the prosthesis, infection, or fractures. In revision surgery, the old prosthesis is removed and replaced with a new one. It is more complex than a primary knee replacement and may require additional procedures to correct bone damage or realign the knee joint.

 

6. How long does knee replacement surgery take?
 

Knee replacement surgery typically takes 1 to 2 hours for a primary procedure. However, revision knee replacement surgeries may take longer due to the complexity of removing the old prosthesis and addressing any additional issues. You will be under general or regional anaesthesia for the surgery, and your surgeon will provide details on the specific approach for your case.

 

7. What is the recovery time after knee replacement surgery?
 

Recovery time can vary based on the type of surgery and the individual’s overall health:

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• Primary knee replacement: Most patients can expect to stay in the hospital for 1-3 days and will be able to walk with assistance within the first day or two after surgery. Full recovery usually takes 6-12 months, with the majority of people returning to normal activities within 3 to 6 months.

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• Revision knee replacement: Recovery may take longer due to the complexity of the surgery, with full recovery typically taking 9-12 months.

 

Physical therapy plays a key role in rehabilitation and helps restore mobility and strength to the knee joint.

 

8. What are the risks and complications of knee replacement surgery?
 

While knee replacement surgery is generally safe, there are potential risks and complications, including:

• Infection at the surgical site

• Blood clots in the leg or lungs

• Implant failure (particularly in revision surgeries)

• Joint stiffness or instability

• Nerve or blood vessel damage
  Your surgeon will discuss these risks with you in detail and take precautions to minimise them.

 

9. How long will my knee replacement last?
 

Modern knee implants are designed to last for 15-20 years or longer, although this can vary depending on factors like your activity level, weight, and whether you’ve had a revision surgery. Generally, younger and more active individuals may experience wear and tear sooner, which could eventually necessitate a revision knee replacement.

 

10. Will I be able to return to sports after knee replacement surgery?
 

After primary knee replacement, most patients can return to low-impact activities like walking, swimming, or cycling. High-impact activities such as running or playing contact sports are generally not recommended after total knee replacement due to the stress it places on the artificial joint.
 

After unicompartmental knee replacement, patients may have more flexibility to engage in some sports, but again, high-impact activities should be avoided.
 

Patients who have had revision knee replacement may face more limitations based on the complexity of the surgery.

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11. How can I manage pain after knee replacement surgery?
 

Pain management strategies after knee replacement include:

• Medications: Your doctor will prescribe pain relievers, such as opioids for the first few days post-surgery, transitioning to non-steroidal anti-inflammatory drugs (NSAIDs) as healing progresses.

• Physical therapy: Regular exercises help with mobility and pain relief.

• Ice, elevation, and compression: These help reduce swelling and discomfort.

• Regional or local anaesthesia: This may be used to numb the knee for a period after surgery, minimising pain during the early stages of recovery.

 

12. How do I prepare for knee replacement surgery?

Prior to surgery, you will undergo a series of pre-operative evaluations, including physical exams, blood tests, and imaging (X-rays or MRI) to assess the condition of your knee. Your surgeon will provide instructions on how to prepare, which may include:

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• Pre-operative exercises to strengthen muscles around the knee.

• Arranging for post-surgery assistance at home.

• Stopping certain medications (e.g., blood thinners) a week or two before surgery.

 

13. Will I need physical therapy after knee replacement surgery?
 

Yes, physical therapy is a crucial part of your recovery process. Therapy will start within a day or two of surgery to help you regain mobility, strength, and flexibility. A personalised rehabilitation plan will guide you through the exercises and activities that help optimise your recovery.