The worn ends of the bones in your knee joint are removed and replaced with metal and plastic parts a prosthesis which have been measured to fit. You may have either a total or a partial knee replacement. This will depend on how damaged your knee is. Total knee replacements are the most common. Read more information about what happens on the day of your operation.
In a total knee replacement, both sides of your knee joint are replaced. The procedure takes 1 to 3 hours:. You're likely to still have some difficulty moving after your operation, especially bending your knee. Kneeling may be difficult because of the scar. If only one side of your knee is damaged, you may be able to have a partial knee replacement. This is a simpler operation, which involves a smaller cut and less bone being removed. It's suitable for around 1 in 4 people with osteoarthritis. The advantages of partial knee replacement include a shorter hospital stay and recovery period.
Blood transfusions are also rarely needed. This type of joint replacement often results in more natural movement in the knee and you may be able to be more active than after a total knee replacement.
Talk to your surgeon about the type of surgery they intend to use and why they think it's the best choice for you. If only your kneecap is damaged, an operation called a patellofemoral replacement or patellofemoral joint arthroplasty can be performed. This is a simpler surgery with a faster recovery time. However, the long-term results are still unclear and it's not suitable for most people with osteoarthritis.
The surgeon makes a smaller cut than in standard knee replacement surgery. Crunching sounds as you climb stairs, chronic aching and swelling: Knee osteoarthritis is a real pain. Getting a knee replacement is one approach, but you may not need surgery, at least not right away. And some patients cannot undergo knee replacement surgery for various reasons.
Other people with knee pain are too young for a knee replacement — the artificial knee is only likely to last 15 or 20 years, after which the person may need revision surgery. Extra weight puts pressure on the knees and increases stress on the joint, increasing pain and making it hard to exercise. Research compiled by the Johns Hopkins Arthritis Center confirms that carrying extra pounds raises your risk of developing knee arthritis and speeds up the destruction of cartilage that cushions the joint.
If you are overweight or obese, consulting with a nutritionist or a bariatric specialist may be the right place to start. Strengthening the quadriceps and hamstring muscles in the leg is going to help reduce pain and make it easier to stay mobile. Experts recommend a regular low-impact exercise, such as riding a bike or walking on a treadmill. A course of physical therapy can really help. A physical therapist can work with you and put together an individualized program.
Except in very rare cases, the American Association of Hip and Knee Surgeons advises against using opioid medications for knee osteoarthritis. Opiate pain relievers, in addition to being addictive, are not proven to address knee pain over the long term any better than nonsteroidal, anti-inflammatory drugs NSAIDs.
Even over-the-counter drugs like naproxen and ibuprofen can have side effects, so check with your doctor. 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. Exercising the main muscle groups around your knee is very important both before and after having a knee replacement.
You can download a selection of exercises that are designed to stretch, strengthen and stabilise the structures that support your knee. Try to perform these exercises regularly, for instance for 10 minutes six to eight times a day. Most knee joint operations are problem-free but about 1 person in every 20 may have complications. Most of these complications are minor and can be successfully treated. The risk of complications developing will depend on a number of factors including your age and general health.
In general, a younger patient with no other medical problems will be at a lower risk of complications. It's important to remember that any drugs used throughout your stay in hospital, for example anaesthetic or painkillers, may also have side-effects. Your surgeon or anaesthetist will be able to discuss these with you.
This is because of changes in the way blood flows and its ability to clot after surgery. There are various ways to reduce the risk of this happening, including special stockings, pumps to exercise the feet and drugs that are given by injection such as heparin. Blood-thinning drugs can increase the risk of bleeding, bruising or infection so your surgeon will need to balance these risks. Rivaroxaban, dabigatran and apixaban are tablets to help prevent DVT which have recently become available as an alternative to injections.
The tablets are more convenient than injections, which makes them easier to take at home. However, they still carry a risk of bleeding. In a very small number of cases a blood clot can travel to the lungs, leading to breathlessness and chest pains. In extreme cases a pulmonary embolism can be fatal. This happens in about 1 in 50 cases. Usually the infection can be treated with antibiotics. About 1 in patients develops a deep infection, which may mean removing the new joint until the infection clears up.
Very rarely, the leg may have to be amputated above the knee and replaced with an artificial leg — but this is extremely unusual. The bone around the replacement joint can sometimes break after a minor fall — usually after some months or years and in people with weak bones osteoporosis. When a mobile plastic bearing is used there is a small risk of dislocation of the knee, and this would need further surgery. For most people, pain gradually eases during the first few months after surgery.
However, some people have ongoing pain or develop new types of pain. This complication is known as complex regional pain syndrome. Some hospitals have pain clinics that can help with this. Some people experience continuing or increasing stiffness after surgery. Usually this resolves with exercise, and as the swelling improves. Pain may contribute to this complication by stopping the patient from doing physiotherapy exercises and allowing scarring to glue together the soft tissues around the joint.
Occasionally knee stiffness may be treated by a manipulation of the joint under anaesthetic, followed by intensive physiotherapy. Osteoporosis is a condition that causes the bones to become fragile, so that they break more easily. Learn about the causes, symptoms and treatment. If you've had a partial knee replacement, you're more likely to need a repeat operation — about 1 person in 10 needs further surgery after 10 years.
Some people need a repeat knee replacement operation on he same knee. This is called a revision. The repeat operation is more difficult than the first, but the techniques are becoming more routine and more successful all the time. We're funding research to improve patient experience before, during and after knee replacement surgery. This includes a project based at the University of Sheffield which aims to help patients make informed decisions about their surgery.
The research team will use the UK National Joint Registry dataset to develop and validate a personalised, web-based decision aid to help patients considering knee joint replacement to make informed choices about their treatment. We're also supporting research to improve the outcome of knee replacement surgeries, such as a project aimed at increasing the understanding of why joint replacements sometimes fail by investigating whether there are genetic risk factors that influence surgery outcome.
This research has the potential to improve patient experience and increase the life of the joint replacement. Our TRIO study is investigating the effect of targeting specific physiotherapy at patients who are functioning poorly after knee replacement surgery. The aim of this study is to find out whether this early treatment improves pain, satisfaction and function after a year. If successful, it could benefit more than 15, patients per year in the UK alone, who are not satisfied with their knee replacement one year after the operation.
We're funding research which aims to provide a standardised approach and assessment for virtual clinic follow-up of total joint replacement patients and subsequent management of patients identified as 'at risk' by this approach. This study would enable us to deliver better and more streamlined after care for patients.
We're also funding research which is investigating alternative approaches to total knee replacement. For example, total knee replacement is not recommended for many young people. If successful, this technique could prevent osteoarthritis patients from needing total joint replacement. Super-fit Alan thought his days of fell-running were over when surgeons told him the articular cartilage in his knee had worn away and knee replacement surgery was his only option.
He ended up at the Robert Jones and Agnes Hunt Orthopaedic Hospital RJAH in Oswestry as the first person to undergo surgery to repair his osteoarthritic knee with a combination of stem cells and chondrocytes. This is the procedure now to be trialled as part of the Arthritis Research UK programme grant. He paid privately to have the operation and was fully aware of the unpredictable outcome of such surgery.
The procedure involved two operations; first to take stem cells from his pelvis, which were grown in the laboratory, and the second to implant them back into his knee six weeks later.
Progress afterwards was slow and laborious. Alan was offered a full rehabilitation programme by the Oswestry team but also took advantage of help from close friend David Galley, a physiotherapist with Liverpool FC, who devised a rigorous exercise regime.
Alan started as soon as he was off crutches six weeks after surgery. For two years he did aqua jogging and then cycling, and lots of exercises to strengthen his quadriceps muscles. Then Alan started running again, taking part in a five-mile trail race. After suffering no ill-effects he started to run again in earnest.
He completed the Grizedale Duathlon: four miles of fell running and a mile bike ride, followed by a further four mile fell race. Although his knee was a little sore afterwards, an ice pack applied on the way home did the trick. I went back to hospital last year for an MRI scan and the cartilage had regrown. The nurse told me it was cartilage they would expect to see in a 30 or year-old. You can read more of our supporter stories on our Your stories page. Knee replacement surgery.
Download versus Arthritis - Knee replacement surgery information booklet. Print this page. Do I need surgery? Related information. Common types of surgery. The four main types of knee replacement surgery are: total knee replacement unicompartmental partial knee replacement kneecap replacement patellofemoral arthroplasty complex or revision knee replacement.
Read more about the four main types of knee replacement surgery:. Total knee replacement Unicompartimental partial knee replacement Kneecap replacement patellofemoral arthroplasty Complex or revision knee replacement. Total knee replacement.
Unicompartimental partial knee replacement. Kneecap replacement patellofemoral arthroplasty. Complex or revision knee replacement. Some people may need a more complex type of knee replacement. The usual reasons for this are: major bone loss due to arthritis or fracture major deformity of the knee weakness of the main knee ligaments. There are several possible advantages of knee replacement surgery. These include: freedom from pain improved mobility improved quality of life because everyday activities and exercise are easier.
The possible disadvantages of knee replacement surgery include: A replacement knee can never be quite as good as a natural knee — most people rate the artificial joint about three-quarters normal. You may also be aware of some clicking or clunking in the knee replacement.
You may have some numbness at the outer edge of the scar to begin with. A replacement knee joint may wear out after a time or may become loose. Alternatives to surgery.
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