Surgery is offered when you have a condition that is affecting your everyday activities due to pain or stiffness, as well as your ability to sleep and where other treatments have failed to improve your symptoms.
During surgery, which is normally carried out under a regional anaesthetic, the surgeon removes the damaged cartilage from the end of the femur (thigh bone), top of the tibia (shin bone) and the patella (knee cap). The end of the femur is resurfaced with a metal femoral component/prosthesis, as is the top of the shin – this then forms the main part of the new knee joint. The patella is resurfaced to replace this joint (patellofemoral joint) thus replacing all the worn moving parts of the knee allowing the joint to move smoothly without pain. These components are held to your bone with cement.
Complications following knee replacement surgery are rare. However, they can include:
You’ll be in hospital for 1-4 nights and will be shown how to walk using crutches (which you may need to use for up to six weeks).
Depending on the kind of work you do, you may need up to six weeks off work. However, your consultant will be able to advise you about this as everyone is different and your rate of recovery may be different from other people’s. We normally recommend that you don’t work at all for the first 4 weeks, gradually returning to normal after six weeks (if your job mainly involves sitting down). Commuting during rush hour is not recommended for at least six weeks after knee replacement surgery. Manual workers may need up to three months to return to normal.
The DVLA states that it’s the responsibility of the driver to ensure they are always in control of the vehicle. A good guide is if you are confident walking without crutches and can get into your car without help, which is usually around six weeks after surgery. Vehicle insurance companies also usually suggest a six-week period off driving, although you should always check with your car insurance company first.
It’s important to discuss any concerns you may have with your specialist and to have realistic expectations about what is possible with this procedure. In most cases, people who have total knee replacement surgery have dramatically reduced levels of pain and increased ability to carry out everyday tasks. However, it is recommended to avoid impact sports that put particular stress on the joint such as running, jumping, downhill skiing, hockey, football, rugby, and squash. Sports that are less likely to cause problems include walking, swimming, golf, cycling and other low impact activities.
Your knee replacement should continue to improve for up to a year after surgery, and sometimes longer for younger patients.
Most people can bear weight on their leg soon after the operation and should be able to walk confidently without crutches within six weeks. For the first 2 weeks the focus is on minimizing swelling and pain (ice is helpful in this phase) Improving range of motion (aiming for 0-90 degrees bend). From 2-6 weeks focus continues to be increasing the range of motion and developing strength in the surrounding muscles, and improving balance. Using an exercise bike from two weeks onwards is encouraged.
You will also be advised to arrange to see a physiotherapist so that you can begin to follow a rehabilitation programme that will help you return to fitness as soon as possible.
knee replacements may set off airport security detectors but in most cases, you won’t need to go into great detail about your surgery with the security staff; many people have had some type of surgery involving a metal device and a brief explanation should be enough.
Looking after your replacement knee will help protect and extend its life. You can do this by:
A 70y old patient who had arthritis in both knees, treated with bilateral knee replacements:
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