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Total Knee Replacement

A knee replacement, or arthroplasty is a surgical procedure in which the arthritic portions of the kneeare removed and replaced with a new, artificial joint. The operation involves removing the damaged surfaces of the knee and replacing them with an artificial joint containing metal and plastic component. It is an extremely successful operation for the vast majorityof people.

THE ANAESTHETIC

You will typically have a regional anaesthetic (spinal anaesthetic), or occasionally for medical reasons a general anaesthetic, and sedation. The operation will take between 1 and 2 hours.

THE PROCEDURE

A long cut, usually over the front of your knee is made. The bottom end of your thighbone is trimmed to remove the damaged surface and is then shaped to fit the metal bit of the knee replacement. The damaged top end of your shin bone is removed to make a flat surface. The new parts are fitted over both bones, and tested to make sure they fit and the joint works well.

Once the new parts are fitted and working the wound will be closed using stitches or staples and covered with a large dressing.

TIPS FOR A SUCCESSFUL OUTCOME

Knee replacements are generally very successful operations. However, it is important to be patient, expect that recovery will take at least 6-9 months to see significant improvement to your symptoms and function. It is important you understand that compliance with physiotherapy and exercises after knee replacement correlates strongly with an excellent outcome. It is also crucial you understand what may or may not be achievable, that is, your expectations must match what the surgeon and physio believes can be achieved in terms of pain relief and improvement in function from having a knee replacement.

In short, be patient and rehab well to ensure a good outcome. Mr Kim and his team will ensure that you are seen by an appropriate physiotherapist and you are fully aware of what is required pre and post procedure in terms of patient education, exercises and a fitness and strengthening program of exercises post surgery.

Total Knee Replacement

Total knee replacements may be indicated for patients with advanced knee osteoarthritis in this section I will outline the indications for total knee replacement, the procedure, risks and benefits associated with total knee replacement.

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Partial Knee Replacement

The knee joint consists of the ends of the thigh bone (femur) and top of the shin bone (tibia), which normally glide smoothly as they are lined by smooth articular cartilage (hyaline cartilage). The joint is held in place by ligaments and muscles and covered in front by the patella (the kneecap).

Due to ‘wear and tear’ (see ‘Knee OA’), the damaged cartilage may cause the joint to be painful, stiff and lose range of movement. A uni-compartmental knee replacement involves removing only the most damaged areas of cartilage and replacing only the damaged surfaces.

A unicompartmental knee replacement can be considered if you have early stage arthritis confined to one part of the knee and lead a relatively sedentary lifestyle, have an intact Anterior Cruciate Ligament (ACL), have no significant knee deformity, and do not have damage to the other compartments.

The benefits of this operation are a smaller incision, and bone removal is much less compared with a total knee replacement, such that if a revision procedure is needed in the future, bone is preserved. It is also associated with less blood loss. The recovery period may be shorter, both the time spent in hospital and the overall time to full recovery. However, not all patients are suitable for a unicompartmental knee replacement.

Partial Knee Replacement

Partial knee replacements may be indicated for patients with localised but advanced knee osteoarthritis either of the inside of the knee (medial compartment) or localised severe arthritis in the knee cap.  In this section I will discuss frequently asked questions regarding partial knee replacements.

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Winston Kim

MBChB, MSc, FRCSGlasg (Tr & Orth)

Consultant Orthopaedic Surgeon

Specialist in Hip and Knee Surgery

CALL US ON  0161 4476753

email us at manchesterhipandknee@gmail.com