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Knee replacement surgery

What is knee replacement surgery?

The knee is divided into three compartments: the medial (inner), the lateral (outer) and the patello-femoral. Any of these compartments can be replaced, without replacing the entire knee joint.

Knee replacement is sometimes the only surgical option available to patients with knee conditions such as arthritis that cause damage to the knee joint, resulting in problems carrying out everyday activities. The aim of the operation is to relieve pain and improve mobility by replacing the worn-out parts of the arthritic knee with specially designed metal and plastic components.

Most knee replacement surgery is carried out on older people, although it can be offered to patients of any age. In most cases, a replacement knee will last over 20 years.

While knee replacement may be the answer for some people, for others – particularly if you are a younger patient, an athlete, or an older patient who is still very active – removing the knee joint, which also means taking away a great deal of healthy tissue, may not be the best option.

In some cases, you may be offered knee realignment surgery (osteotomy) instead; this new procedure can significantly delay, or in some cases even avoid, the need for knee replacement surgery.

Ryan’s bi-lateral knee replacement story

“My range of movement is well in excess of anything I could have imagined and the whole process was far less painful than I had expected. I’m looking forward to the new lease of life this will bring. A huge thank you to Professor Wilson and his team, who were first class in every respect.”

Why might I need knee replacement surgery?

You are more likely to need total or partial knee replacement surgery if you have:

  • Arthritis. Wear and tear arthritis is by far the most common indication.
  • Rheumatoid arthritis
  • Psoriatic arthritis
  • Haemophilia
  • Gout
  • Arthritis caused by a previous knee injury
  • Deformity of bones in the knee
  • Bone death due to poor blood supply (avascular necrosis)

There are two types of knee replacement surgery:

  • Total knee replacement (TKR) where both sides of your knee joint are replaced
  • Partial (half) knee replacement (PKR) where one part of the joint is replaced

In some cases, your consultant may advise that you have an examination of the knee joint under an anaesthetic using keyhole surgery to decide on the option that is best for you.

Total knee replacement (TKR)

This operation, first carried out in 1968, is now very common and involves replacing all the surfaces of your worn-out knee with metal and plastic components. It’s offered when lifestyle modifications, painkillers and physiotherapy haven’t relieved your pain or mobility problems.

Partial knee replacement (PKR)

This operation is offered if only one of the three knee compartments is damaged. In most cases, this is the medial (inner) compartment. As the procedure involves replacing just one part of the knee, the scar tends to be smaller, recovery is faster with less pain, and the range of movement remains better than with a TKR.

Revision total knee replacement (TKR)

If your previous knee replacement hasn’t been successful, you can have a second procedure where some or all of the artificial components in the knee are replaced with new ones. Problems with previous surgery may be due to wear and tear or loosening of the new knee joint, instability due to ligament damage, stiffness, a fracture or, in some cases, infection.

Revision surgery tends to take longer, and is often more complex, than the original knee replacement, with extensive planning and rehabilitation needed to achieve a good recovery. Your consultant will be able to advise you about your surgical options and help you decide which is likely to have the best outcome.

Knee consultants

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