Knee replacement: Procedure, recovery, types

Knee replacement surgery, also known as knee arthroplasty, involves replacing all or some parts of your knee with a prosthesis made from hard-wearing materials. If you’re suffering from arthritis and pain in your knee, this procedure can help you regain mobility and the pleasure of walking without pain. While knee replacement procedures are invasive, they carry a low degree of risk and are often the only effective interventions for long-lasting well-being.

Knee replacement surgery: Who is it for?

Most patients referred for a knee replacement are over 55 but younger patients may benefit from it, too, e.g. after a serious sports injury.

Patients require knee arthroplasty when they experience reduced mobility due to chronic osteoarthritis, a condition characterized by the breakdown of joint cartilage. As the joint is not stable, swelling and pain are seriously limiting regular movements, and patients may be unable to perform normal activities such as climbing stairs or walking. This surgery is typically suggested when alternative therapies such as injections and physiotherapy have not worked or have been ruled out as options in the first place.

Conditions such as bone dysplasia, haemophilia or gout may also cause severe bone damage, making a knee replacement necessary.

How does knee replacement surgery work?

Here’s a step-by-step overview of how a knee replacement surgery typically works:

1. Consultation

Before surgery, you will have a thorough consultation with your physician to understand whether a knee replacement surgery is necessary. If this is the case, you will arrange a date for surgery. You might also be advised to strengthen the knee area with specific exercises as well as to stop any medications you are taking which could conflict with the procedure.

2. Anaesthesia

Surgery will start with the administration of a general anaesthetic. This means that you will be asleep throughout the procedure. A urinary catheter may be inserted.

3. Incision

The surgeon will cleanse the surgical site with antiseptic and then make an incision in the knee area to expose and treat your joint.

4. Application of the knee prosthesis

First, the surgeon will remove the damaged tissue and surface of the knee joint. Then, the prosthesis will be applied. There are different types of prostheses for a knee replacement, and they are typically chosen based on the age of a patient. The most commonly used prostheses, however, are cemented ones, as they have a longer life span. They attach to the bone with surgical cement.

If you are undergoing a total knee replacement surgery, all three parts of the knee will be replaced – the tibia, the femur, and the patella. This is the most common knee replacement procedure. This means that the prosthesis consists of a tibial, a femoral, and a patellar component.

5. Incisions are closed

It is now time for the surgeon to close the incision with stitches and apply a sterile bandage to keep your knee stable and safe. A drainage tube may also be applied to remove excess fluid.

6. Recovery

Now, it’s time for you to recover from surgery and follow the post-op guidelines your doctor has given you.

You should feel pain relief immediately and with time, you will be able to enjoy basic activities like walking again.

Are there different types of knee replacement?

As mentioned earlier, the knee consists of three parts: the femur (thighbone), the tibia (shinbone), and the patella (kneecap).

Ligaments connect your muscles to the bones around your knee, which are covered by cartilage and other soft tissues. These help the bones glide together smoothly. When the cartilage is damaged or degraded, the bones rub together, leading to attrition, inflammation (known as osteoarthritis), and pain. Knee replacement surgery helps regain mobility and reduce pain, as implants resemble the surface of a healthy knee.

Depending on the condition of your knee, and if one or all parts of your knee joint need to be replaced, a specific type of surgery may be performed.

There are two main types of knee replacement:

• Total knee replacement: this procedure involves replacing the entire joint with an artificial prosthesis. This is the most common procedure.
• Partial knee replacement: here, only one damaged component is replaced.

As the name suggests, a total knee replacement is performed when all parts of the knee need to be replaced.

A partial knee replacement, also known as unicompartmental knee arthroplasty, involves removing and replacing damaged cartilage and bone only in one part of the knee. This type of procedure is recommended to patients whose arthritis is present only in one of the knee components, which represents 25% of knee replacement surgery patients.

If you are unsure of what procedure best works in your case, feel free to get in touch with us anytime. One of our doctors will review your medical history and decide with you on the best course of action. To get an idea of the prices for the different procedures and types of implants, feel free to have a look here.

What should you expect after a knee replacement surgery?

Knee replacement is an invasive surgery and recovery time depends on the patient’s conditions, type of surgery, and age. Generally speaking, you can expect recovery to last anywhere between 2 to 3 months. The healing and adjustment process may last up to two years, so it’s important that you take the time to heal and recover at a moderate pace.

You will receive painkillers and anticoagulants right after surgery to ensure that your healing goes smoothly. Physiotherapy is a crucial part of recovery, that’s why you will start rehabilitation the day after surgery. Make sure that you follow the instructions of your physiotherapist. The goal is to gently mobilitate your knee joint and ease the adjustment to your new knee.

Depending on your overall conditions, you should be able to leave our hospital 2 to 3 days after surgery. The doctor will give you post-op instructions and you will be asked to walk with orthopaedic crutches and continue with your physiotherapy plan.