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Knee Replacement Surgery

A knee replacement is a surgery that replaces any damaged bone and cartilage with artificial knee implants.

Also known as: knee arthroplasty. A knee replacement can be total or partial. Sometimes it is also referred to as knee resurfacing, especially when part of the compartment is being replaced.

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Everything you need to know

For many people, a knee replacement is recommended to help treat pain and stiffness in the knee caused by osteoarthritis.
Depending on the extent of damage in your knee, your doctor may recommend a total knee replacement, where all your knee joint is replaced, or a partial knee replacement where much of your knee joint remains in place and only parts are replaced.
It is important to note that the surfaces of the joint are replaced and not the joint itself. This means you will still retain all your bone and most of your ligaments.
A knee replacement can last for more than 20 years and should significantly improve your quality of life if you are suffering with chronic knee pain.

Before Surgery

Pre-surgery

Doctors will always try to manage a knee problem with non-surgical treatments first. For someone with knee osteoarthritis, non-operative options include modifying activity, lifestyle changes and weight-loss if appropriate, pain-relief, physiotherapy and knee injections.

However, if the problem gets to a point where the pain is so severe you’re having difficulty with walking, experiencing a general reduction in mobility, or pain at night – and non-operative options are no longer working, then a knee replacement may be the best option.

If you are suffering with knee pain or think you might need a knee replacement, book an appointment with one of our specialist knee surgeons. They will assess your knee and if needed refer you for an up-to-date X-ray to see the extent of damage in your knee. Your doctor will then thoroughly discuss your options with you. If surgery is recommended, they will explain the risks and benefits so you can make an informed decision.

Prehab

If you decide to have surgery, you may need to see a physiotherapist for ‘prehab’. This will aim to increase the range of motion in your knee and strengthen the surrounding muscles.

In the run up to surgery, you should regularly do your prehab exercises as this will lead to better outcomes after surgery.

If you would like physiotherapy help, we have an excellent therapies department at the hospital who can support you before and after surgery.

Pre-Assessment

Before your surgery, you will need to come into hospital for a pre-assessment, where we can check your fitness for surgery. This is a standard check and includes a physical exam, blood tests, heart and lung function tests as well as an MRSA test. We will also give you some specific antibacterial soap and lotions to use in the run up to the procedure, which will help reduce your risk of contracting MRSA.

If you take any blood thinners—for example, warfarin or aspirin, tell your doctor straight away, as you may need to stop taking these or modify your intake from a week before surgery. Your doctor will give you specific instructions if this is the case. You should also tell your doctor if you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.

Surgery day

You should stop eating six hours before surgery. Two hours before, you should stop drinking (including water), chewing gum and sucking boiled sweets. Brush your teeth with toothpaste only on the morning of surgery.

Wear loose, comfortable clothes and bring a small bag with things you might need during your stay. Items to remember include a toothbrush and toothpaste, your phone and a charger, and any prescription medications. Your doctor will let you know if you can take any medications with a sip of water before surgery or if you should wait until after.

Once you have arrived and are settled in your room, a nurse will monitor your vital signs (such as body temperature and blood pressure) and run through your medical history, medications and emergency contacts.

Your doctor will then once again run you through the procedure and ask you to sign a consent form for surgery.

During Surgery

Before the surgery starts, you will be anaesthetised. There are different options, including general anaesthesia where you are unconscious and need a breathing tube to help you breathe, and spinal where anaesthetic is injected into your spine to numb the lower half of your body and you are awake. With spinal, you can also be given sedation to help you relax.

Most people will have a total knee replacement. This is where the lower end of your thighbone and the upper end of your shin bone are replaced with implants made from metal (cobalt chrome/titanium) and plastic (poly ethylene).

If you only have arthritis in half the knee, you can have a partial knee replacement where only the bone on the affected side is replaced. The operation itself will be very similar. However, you should have a smaller scar after and recover more quickly.

To finish, your surgeon will close your incisions with stitches or clips and then cover them with a dressing and bandage.

Typically, a knee replacement takes between 1-2 hours.

After Surgery

Once we’re happy you’re doing well, we will take you to your private room where you can start your recovery.

During your stay, our nursing team will make regular checks to make sure your recovery is going to plan. You will also be visited by a physiotherapist and an occupational therapist if needed. You’ll be encouraged to get up and walk around as soon as possible, with the help of crutches or a walking frame. Before you are discharged, you will need to be cleared by the physiotherapist and nursing team. Your surgeon will also visit you and make sure you are happy.

You should be able to go home after 1 to 3 days.

If possible, you will need someone to collect you from hospital and help you for a couple of weeks post-surgery as well, as your knee will be bruised, swollen and quite painful for 1-2 weeks after surgery. During this time, take your prescribed painkillers, apply a cold wrap to your knee, and keep your leg elevated as much as possible. When moving around use crutches as you should not put too much weight on your knee at this point.

It will take approximately two weeks for your wound to heal, and you should see your doctor at this point for a post-surgery check, where any stitches or clips will be removed.

From 2 weeks onwards, you should do your physiotherapy exercises regularly as these will help improve your balance, flexibility in your knee, and increase the strength in the surrounding muscles. You should be able to start driving again after 6 weeks if you had a full knee replacement or 3 weeks if you had a partial knee replacement.

In the weeks following an operation, patients have a slightly higher risk of a blood clot, so will need to avoid flying. You should wait six weeks before taking a short-haul flight (under six hours) and 12 weeks before taking a long-haul flight.

The recovery time for knee replacement surgery depends on the type of surgery you had. For a total knee replacement, full recovery may take up to a year, but you should already be noticing a significant improvement in your mobility and knee function after 6 months. If you had a partial knee replacement, you should feel an improvement after 4 months.

A physiotherapist can help guide you through the recovery process – our hospital has a talented team who can support you throughout your recovery.

How to pay for your treatment

If you’re… paying for yourself

Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.

For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.

 

If you’re… insured

St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.

01

Appointment

You will have an initial consultation with a specialist knee surgeon.

02

Treatment plan

During this appointment, you will go through your medical history, have a knee exam and if needed, be referred for an up-to-date scan (such as X-rays or MRI) of your knee. If surgery is recommended, your doctor will explain the risk and benefits of surgery and what to expect from recovery. Together, you will decide whether knee replacement surgery is the best option for you.

03

Prehab

Your knee needs to be in the best condition possible before surgery, as this will lead to better outcomes. Once your swelling has gone down, you should follow your physiotherapist’s exercise programme.

04

Pre-Assessment

If you decide to go ahead with knee replacement surgery, you will need to come in for a pre-assessment, which is a standard ‘fitness for surgery’ check.

05

Surgery

You will be able to walk the same day with the help of crutches or a walker. You should be able to go home after 1-3 days.

06

Aftercare

You will need to keep your wound clean and dry, take pain relief and have physiotherapy consistently. You will not be able to fly short haul for six weeks or long-haul for 12 weeks. We have an excellent therapies team at our hospital that can support you throughout your recovery.

07

Follow-Up

You will have a follow-up appointment with your doctor at two weeks, where any stitches or clips will be removed. You may need further check-ups at 6 weeks, 12 weeks, 6 months and 1 year.

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