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Knee Replacement Surgery

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The surface in the bones in a normal knee joint is covered with a layer of articular cartilage. Arthritis is a condition where this articular cartilage surface is damaged and this can often result in pain, stiffness and loss of function. Symptoms can include difficulty with walking, dressing and sleeping.

Replacement surgery involves replacing this worn joint surface with a metal surface. The worn surface of the knee is re-lined with a metal surface.

The knee joint is divided into three portions or compartments. Medial, lateral and patello-femoral.

Knee replacement surgery can involve replacement of individual compartments of the knee or all of the knee joint compartments.


Uni-compartmental or partial knee replacement

If the medial (inside) compartment or the lateral (outside) compartment of the knee is affected by arthritis and the other compartments are well preserved, then a uni-compartmental replacement can be considered.

This operation involves replacement of only the worn portion of the knee. This has a number of advantages over total knee replacement. The recovery from this operation is quicker. The major ligaments of the knee can be preserved and the range of movement is generally greater when compared to a total knee replacement.

Patello-femoral joint replacement. If the patella (kneecap) and the trochlear (portion of the thigh bone that the kneecap moves over) are worn, then this portion of the knee can be replaced in isolation. This is referred to as a patello-femoral joint replacement. This is suitable for patients where the remainder of the knee joint surfaces are well preserved and not significantly affected by arthritis.

Total knee replacement

In many patients the whole of the knee joint is worn and a total knee replacement is required to re-line all of the joint surfaces.

The procedure can be performed under general or spinal anaesthetic. Often nerve blocks are used and these are very effective in reducing pain after the operation. Patients are normally in hospital for 5 days and will normally mobilise on crutches for between 4-6 weeks post-operatively.

It normally takes 3 months to recover from the procedure and the knee will continue to improve for up to a year following the operation.

The aim of the operation is to relieve pain and improve function, including walking and stair climbing. Many patients are able to play golf following replacement surgery and doubles tennis.

It would be reasonable to expect to return to activities such as cycling, but knee replacements are not intended to allow activities such as running or contact sports. The majority of patients are happy with the results of knee replacement.

A knee replacement is expected to last at least 10 years and in many cases replacements can last 15-20 years.


Potential complications with knee surgery

There are risks with all surgical procedures. The risk of the anaesthetic itself with modern anaesthetic techniques is very low.

There are general risks of surgery, which include blood clots, infection of the wound, post-operative bleeding, difficulty passing urine, chest infections and heart attacks or strokes.

Deep infection of the replacement is fortunately uncommon, occurring in 1-2 per thousand cases. Risk of infection is reduced by performing the operation in a clean, laminar flow theatre environment. The surgical team wear sterile clothing and antibiotics are given around the time of the operation.

Deep vein thrombosis can occur after surgery and the risk of this is reduced by using stockings in the post-operative period and giving preventative thinning blood agents around the time of the surgery and for several weeks post-operatively.

Patients can experience numbness on one side of the scar and this will return.

A foot drop can occur following damage to one of the nerves on the side of the knee, this generally resolves over a period of days to weeks. Long term permanent foot drop is rare.

Early failure of the knee replacement is very uncommon, but knee replacements have a limited life span and over time will wear and loosen.

How to find us

Nuffield Health Bournemouth Hospital 67 Lansdowne Road Bournemouth BH1 1RW

Harbour Hospital, St Mary's Road, Poole, Dorset. BH15 2BH