Knee Replacement
Regain Your Mobility
Knee replacement surgery is a procedure to replace your knee joint with artificial parts (prosthesis) if it has been damaged or worn away. Although there are several conditions which may lead to the need for a knee replacement, arthritis is the most common reason.
About your knee joint

The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia). The smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) are the other bones that make the knee joint. It is this complexity and stress which can cause arthritis.

About your knee replacement

Knee replacement surgery (arthroplasty) is a routine operation that involves replacing a damaged, worn or diseased knee with an artificial joint. Knee replacement surgery is usually necessary when the knee joint is worn or damaged to the extent that your mobility is reduced and you experience pain even while resting.

Knee replacement surgery – whether total or partial – is an effective treatment for degenerative arthritis in the knee joint.

Speak to your surgeon if you have any questions about the type of replacement you are having. You will meet them before your operation to discuss your care. It may be different from what is described here as it will be designed to meet your individual needs.

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Self pay patients can pay the hospital direct for rapid access to premium services. You will have a number of treatment options which may affect your final bill. Please contact us if you wish to discuss this further.

We partner all major health insurers. Where your policy provides cover you can visit us as a private patient for rapid access to premium services.


Deciding on knee replacement

It is important to consider the advantages and disadvantages of knee replacement and how important each of these is to you. Your doctor can help you to make a decision that is right for you. Here are some pros and cons that you should consider before deciding whether a knee replacement is right for you

Pro's


• After a knee replacement most people do not have knee pain anymore so you do not have to take painkillers.

• Knee replacement can help you move around better.

• Improved quality of life because everyday activities and exercise are easier.

Cons


• A replacement knee can never be quite as good as a natural knee. Most knee replacements are not designed to bend as far as your natural knee.

• A knee replacement can wear out with time. This depends on your body weight and how active you are. About 19 in 20 knee replacements will last around 10 years.


What are the alternatives to knee replacement

Your surgeon will usually only recommend you have surgery if non-surgical treatments no longer help to reduce your pain or help you walk more easily. These include taking painkillers, having steroid injections in your knee joint, or using physical aids like a walking stick.

Preparing for your treatment

Smoking Cessation
Your surgeon will explain how to prepare for your operation. If you smoke, you will need to stop because it increases your risk of getting a chest and wound infection, which can slow your recovery.

Weight Loss
If you are overweight, it’s a good idea to try and lose weight. It may help to reduce the strain on your hip and lower your risk of complications of surgery.

Medication
If you take some types of medicines such as hormone replacement therapy, you might need to stop about four weeks before your operation. Tell your surgeon about any medicines you take so they can advise you.

Anaesthesia
The operation can be done under spinal or epidural anaesthesia. This completely blocks feeling from below your waist, but you will stay awake during the operation. Or you may be able to have the operation under general anaesthesia, which means you will be asleep during the operation. Your surgeon will let you know which type of anaesthesia is best for you.

Fasting
An anaesthetic can make you sick so it’s important that you don’t eat or drink anything for six hours before a general anaesthetic. Follow your anaesthetist’s advice. If you have any questions, just ask.

Communication
Your surgeon will discuss with you what will happen before, during and after your procedure, and any pain you might have. This is your opportunity to understand exactly what will happen.

Consent
You may be asked to sign a consent form. Your surgeon may also ask you to give your consent to have your name on the National Joint Registry. This is used to follow up the safety, durability and effectiveness of joint replacements and implants.

Compression Socks
You may need to wear compression stockings during the operation to help prevent blood clots forming in the veins in your legs - deep vein thrombosis (DVT). You may also need to have injections of a medicine (or tablets) to prevent DVT.

Your Questions
You might find it helpful to prepare some questions to ask about the risks, benefits and alternatives to the procedure. This will help to inform you about the procedure so you can give your consent for it to go ahead.


What we do during your surgery

A knee replacement operation usually takes an hour to 90 minutes.

During a knee replacement your surgeon will make a single cut down the front of your knee. They will then remove any parts of your knee that are causing problems and replace with an artificial knee joint made of metal, plastic or ceramic. A flexible cushion made of polyethylene is attached on top of the new tibia surfaces. This spacer acts as a shock absorber between the two new prosthetic surfaces. Your knee replacement is fixed to the bone using acrylic cement or special coatings on your knee replacement that bond directly to the bone.

What to expect afterwards

You might have some discomfort as the anaesthetic wears off. But you will be offered pain relief as you need it. You may not be able to feel or move your legs for several hours after a spinal or epidural anaesthetic.

A physiotherapist will usually visit you after your operation and will come back regularly afterwards. They will help you out of bed and to start walking using crutches or a walking frame as soon as it is safe to do so. They will give you some exercises to do. It is important to do these as often as they tell you to. They are designed to help your recovery by bringing back movement and strength in your knee.

You will need to stay in hospital until you are able to cope on your own at home. This is usually between three and five days but it might be sooner if you are recovering well. When you are ready to go home, ask a friend or your family to drive you. Your nurse will give you some advice about caring for your hip and a date for a follow-up appointment.

The healthcare team will tell you if you need to have any stiches or clips removed, or dressings changed.

Side-effects of knee replacement

As with every procedure, there are some risks associated with knee replacement surgery. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your surgeon to explain how these risks apply to you.

Side-effects are the unwanted, but mostly temporary effects you may get after having the procedure.

Side-effects of knee surgery include:

• A sore knee and leg for a few weeks

• Swelling in your leg – this might last for several weeks

• A patch of numb skin next to the scar on your knee, this usually becomes less noticeable with time

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Complications

Complications are when problems occur during or after the operation. Complications of knee replacement can include the following:

Pain
The healthcare team will give you medication to control the pain and it is important that you take it as you are told so you can move around as advised.
Bleeding
Bleeding during or after the operation. You may need a blood transfusion.
Blood Clot
Developing a blood clot, usually in a vein in your leg -deep vein thrombosis (DVT).
Infection
Your surgeon may prescribe you antibiotics during and after surgery to help prevent this.
Scarring
Unsightly scarring of your skin, although knee-replacement wounds usually heal to a neat scar.
Nerve Damage
Damage to nerves around your knee, leading to weakness, numbness or pain in your leg or foot.
Split in the Bone
Split in the bone when your knee replacement is inserted, if the bone is weak.
Ligament Damage
Damage to ligaments or tendons near your knee.
Dislocation
Dislocation of your knee replacement. You will usually need another knee operation, sometimes as an emergency.

0 %

Surgical Site Infections


Are there any sports I shouldn't do?

The healthcare team will tell you when you can return to normal activities.

Exercise and sport are recommended after knee replacement, apart from contact sports, which may weaken the cement and lead to loosening of the joint components. Recreational sports – including golf, tennis and skiing – will gradually become possible depending on how fit and sporty you were before the operation. Cycling is a very good way of building up strength and mobility after knee surgery.

What can I do to make my recovery easier?

It is important that you are as fit and healthy as possible before your operation. You can also prepare your home for when you return from hospital.

More information
If you are overweight or obese, it increases your risk of complications during or after a knee replacement. So your surgeon might advise you to lose some weight before your operation.

It is also a good idea to exercise to prepare your upper body for using walking aids. And try to strengthen your leg muscles too, as it will help you recover. Ask your surgeon or physiotherapist for advice on the type of exercises to do.

Try to prepare your home for when you return from hospital. You could rearrange your furniture to make it easier to move around safely. And place items that you use often at arm level, so you do not have to reach for them. An occupational therapist is a good source of advice on aids for your home. Stock up on frozen or tinned food too so you do not need to go shopping immediately after your surgery. Or do an online shop to be delivered when you get home.

If possible, ask friends or family to stay with you for a couple of weeks after the operation to help you while you recover.


Your Consultants

At HMT Sancta Maria you will always see the same consultant throughout your patient journey.
We believe that this makes a world of difference to your experience with us.




"To all staff day and night here at Sancta Maria. Thank you very much for the excellent care, support and lovely food I have received during and following my knee replacement. You all make a great team".


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