Knee Replacement (Arthroplasty) Guide

Knee replacement, also known as knee arthroplasty, is a surgical procedure to replace damaged or worn-out knee joint surfaces with artificial implants. It relieves pain and restores function in individuals suffering from severe knee arthritis or injury. The artificial joint, made of metal and plastic components, mimics natural knee movement.

Procedure Classification

Surgical and Rehabilitative Procedure
Knee replacement is a major surgery that involves removing and replacing the damaged joint. It requires a combination of surgery and post-operative rehabilitation to achieve full recovery and restore mobility.

Knee Replacement Statistics

In the UK, approximately 100,000 knee replacements are performed annually. It is one of the most common and successful orthopedic procedures, with 85–90% of implants lasting 20 years or more. The majority of patients experience significant pain relief and improved mobility.

Types of Knee Replacement

1. Total Knee Replacement (TKR): The entire knee joint is replaced with artificial components.
2. Partial Knee Replacement (PKR): Only the damaged part of the knee is replaced, preserving healthy bone and tissue.
3. Kneecap Replacement (Patellofemoral Arthroplasty): Focuses on replacing the kneecap and the groove it rests in.
4. Revision Knee Replacement: Performed to replace a failed or worn-out knee implant.

Anatomy and Physiology

Knee replacement focuses on these structures:

• Femur (thighbone): The upper part of the knee joint.
• Tibia (shinbone): The lower part of the knee joint.
• Patella (kneecap): Covers and protects the knee joint.
• Cartilage and Ligaments: Provide cushioning and stability to the knee.

Who Needs Knee Replacement?

Individuals with severe knee pain and reduced mobility may need knee replacement if they have:

• Osteoarthritis
• Rheumatoid arthritis
• Post-traumatic arthritis
• Knee deformities or injuries
• Failed previous knee surgery

Costs & Coverage

In the UK, knee replacement surgery is available on the NHS, which covers the full cost for eligible patients. For private care, the procedure typically costs between £10,000 and £15,000, depending on the hospital and surgeon. Private insurance often covers the surgery if deemed medically necessary.

Health Symptoms & Illnesses

Knee replacement is commonly performed for:

• Severe knee pain that limits daily activities
• Swelling and stiffness that reduce knee mobility
• Deformity of the knee joint
• Joint damage from arthritis or injury

Health Professionals

1. Orthopedic Surgeons – Perform knee replacement surgery.
2. Anesthetists – Manage anesthesia and patient safety during surgery.
3. Physiotherapists – Assist with post-operative rehabilitation and mobility recovery.
4. Rheumatologists – Diagnose and manage arthritis-related knee problems.
5. Occupational Therapists – Help patients adapt to daily activities after surgery.

Questions to Ask

• What type of knee replacement is best for me?
• What type of anesthesia will be used?
• How long will I be in the hospital?
• What is the expected recovery time?
• Will I need physical therapy?
• How long will the implant last?
• Are there risks or complications?
• Can I resume sports or physical activities after recovery?
• How do I prepare for the surgery?
• What alternatives should I consider?

Knee Replacement Process

Before the Procedure

• Medical evaluation and imaging (X-rays, MRIs).
• Blood tests and pre-operative assessments.
• Stopping certain medications and fasting the night before.

During the Procedure

• General or spinal anesthesia is administered.
• The surgeon removes damaged joint surfaces and replaces them with artificial components.
• The surgery takes around 1–2 hours.

After the Procedure

• Pain management with medications.
• Monitoring for complications like blood clots or infection.
• Early mobilization with a physiotherapist.

Recovery Process

• Hospital stay of 2–5 days.
• Physical therapy starts immediately.
• Full recovery takes 3–6 months, depending on the patient’s condition and adherence to rehabilitation.

Preparation

Nutrition Dos and Don’ts

Dos:

• Eat a balanced diet rich in protein, vitamins, and minerals.
• Stay hydrated and consume anti-inflammatory foods.

Don’ts:

• Avoid alcohol and tobacco before surgery.
• Limit processed and sugary foods.

Lifestyle Dos and Don’ts

Dos:

• Exercise to strengthen muscles around the knee.
• Arrange for help at home during recovery.

Don’ts:

• Don’t ignore medical advice.
• Avoid heavy lifting and high-impact activities.

Results

Results are usually available immediately after the surgery regarding implant success. Follow-up visits assess healing progress. Successful knee replacement significantly reduces pain and improves mobility.

Diagnosis

Knee replacement helps diagnose and confirm the extent of joint damage, often revealed through imaging studies and physical examination before surgery.

Risks and Benefits

Risks:

• Infection
• Blood clots
• Implant failure
• Nerve damage

Benefits:

• Pain relief
• Improved mobility and function
• Better quality of life
• Long-lasting results

Alternatives

• Physical Therapy – Strengthening exercises to improve knee stability.
• Medications – Pain relief and inflammation control.
• Injections – Corticosteroids or hyaluronic acid.
• Arthroscopy – Minimally invasive surgery for minor joint damage.

Health Monitoring

After knee replacement, health professionals monitor progress through physical exams, imaging, and tracking mobility improvements. Regular follow-ups are essential to ensure proper healing and implant function.

Clinical Products

1. Pain Management Medications – Prescribed to manage post-operative pain.
2. Knee Braces – For additional joint support during recovery.
3. Compression Stockings – Reduce the risk of blood clots.
4. Wound Care Supplies – For incision care.
5. Mobility Aids – Crutches or walkers for support.

Services

1. Orthopedic Clinics – Specialized care and follow-ups.
2. Physiotherapy Services – Essential for recovery and mobility restoration.
3. Occupational Therapy – Assistance in adapting to daily activities.
4. Private Health Insurance – Covers surgery and rehabilitation costs.
5. Health Apps – Track progress and manage rehabilitation schedules.

Frequently Asked Questions

1. Is knee replacement painful?
   Pain is common initially but improves with proper medication and therapy.
2. How long does the procedure take?
   Around 1–2 hours.
3. When can I walk again?
   Usually within 24 hours with assistance.
4. How long does the implant last?
   15–20 years, depending on activity level.
5. What is the success rate?
   Over 90% of patients experience significant improvement.
6. Will I need physical therapy?
   Yes, it is essential for recovery.
7. What are the risks?
   Infection, blood clots, and implant failure are rare but possible.
8. Can I kneel after surgery?
   It may feel uncomfortable, but it’s possible after full recovery.
9. Is knee replacement safe for elderly patients?
   Yes, with proper evaluation and care.
10. Can I return to sports?
    Low-impact sports are encouraged after recovery.