The knee is the largest and one of the most complex joints in the body. It supports our body weight and is responsible for our ability to move as well as working as a highly efficient shock absorber. Wear and tear, overuse, and injury can all damage the knee, making it painful, stiff and swollen and, ultimately, affecting our quality of life.
If conservative management such as physiotherapy and medication fail to ease symptoms, then totally knee replacement is an effective solution. A knee replacement is a surgical procedure to replace part or all of a damaged, worn, or diseased knee joint with an artificial counterpart.
Typically, a replacement knee can last over 25 years with proper care and minimal strain. Keeping fit and well and maintaining a healthy body weight can contribute to the extended lifespan of the artificial joint.
Even small deviations in the knee joint’s anatomy can have a significant impact on its function. Standard knee replacement prostheses are available in a limited range of shapes and sizes. Although most patients will suit these implants, some have an atypical anatomy which requires a custom-made implant. For these patients, knee implants will be produced that are designed specifically for their knee joint, helping to preserve cartilage and bone structure.
Am I suitable for a knee replacement?
The necessity for knee replacement arises when the knee joint’s wear or damage results in reduced mobility and persistent pain, even during periods of rest. Osteoarthritis is the most prevalent reason for knee replacement, with other conditions, such as rheumatoid arthritis, haemophilia, gout, and knee injuries, also warranting consideration.
Knee replacement is recommended when severe pain, swelling, and stiffness limit mobility, impacting daily life and sleep. If conventional treatments like physiotherapy or steroid injections prove ineffective, surgery becomes a viable option. Consideration is given if tasks like shopping or personal hygiene become challenging, leading to a diminished quality of life.
What does knee replacement surgery involve?
There are two primary types of knee replacement surgery based on the knee’s condition:
Are there any alternatives to knee replacement?
While alternative surgeries exist, their long-term efficacy may not match that of knee replacement. Options include arthroscopic washout and debridement, osteotomy, and mosaicplasty. The choice depends on the individual case and will be discussed with the doctor.
What downtime can I expect after a knee replacement?
Hospital stays typically last one to two days, with recovery times varying based on the surgery type and individual response. After discharge, patients receive guidance on at-home knee care, initial use of walking aids, and exercises from a physiotherapist. Full recovery, involving scar tissue healing and muscle restoration, may take up to a year.
What are the potential risks of a knee replacement?
Though knee replacement is generally safe, potential complications include knee stiffness, wound infection, deep joint infection requiring further surgery, unexpected bleeding, and damage to surrounding ligaments, arteries, or nerves. Blood clots, persistent pain, and fractures around the knee replacement are also rare but possible occurrences, necessitating corrective procedures in some cases.
Can I play sports after my knee replacement?
After undergoing a knee replacement, many patients are keen to resume the sports and activities they previously enjoyed before experiencing the pain and lack of mobility caused by arthritis. Every patient is unique but generally Mr Alazzawi advises against returning to high impact sports such as rugby or football which have a high risk of falling or trauma. Running or jogging will wear the new joint out faster which must be balanced against the benefits of this exercise.
Low impact sports such cycling, hiking, swimming or golf, are encouraged as it is important to keep fit and active. Returning to these sports should only be undertaken when your healing has progressed and you have completed a rehabilitation protocol aimed at improving the flexibility and strength of your muscles and joints.
Mr Sulaiman Alazzawi is a Consultant Orthopaedic and Trauma Surgeon based at St Georges University Hospital and the South West Elective Orthopaedic Centre in Epsom. He specialises in hip and knee replacements and treating painful or failing joint replacements. His private practice is based at Fortius Clinic and Parkside Hospital in Wimbledon and Spire St Anthony’s Hospital in Sutton.
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