Assessment

X-rays are used to assess the damage in a diseased knee. An orthopaedic surgeon will carry out a full assessment of the damage, pain, strength, stability and range of motion of the knee. The surgeon will discuss treatment options based on factors including the extent of the damage, the current levels of pain and mobility, and the overall condition of the knee. They will also assess other factors such as your age, weight, and general health.

Before Your Procedure

You will have an initial consultation with your doctor. You should inform them of any medication you are taking, and you may be advised to pause it before the procedure. You will also be asked to fast from the night before your operation.

Antibiotics will be prescribed before, during, and after your procedure to prevent infection. A nerve block may also be provided to numb the area surrounding the knee.

During the Procedure

Knee replacement can be performed under general or spinal anaesthesia. Under spinal anaesthesia, you will remain conscious, but will temporarily have no feeling from the waist down. The surgery generally lasts around two hours.

A six to ten-inch incision will be made to move the kneecap aside and remove damaged cartilage. The surgeon will prepare the joint surfaces and attach the artificial joint. Before closing the incision, he will fully assess the knee to make sure proper function has been restored.

Risks

A knee replacement procedure carries the standard risks of surgery, such as infection, blood clotting, and nerve damage. However, these are all very rare occurrences. After the surgery, notify your doctor immediately if you notice any symptoms of infection such as fever, chills, redness, swelling, tenderness, or persistent pain at the site of the surgery.

It is possible for the artificial joint to fail, although it happens very rarely. Wear and tear during the post-operative phase,  regular heavy impacts or excessive weight can increase the chances of the joint failing. If it does, further surgery must be performed. Most knee replacements last many years, however.

Consult with your doctor in advance of surgery about any medications you are taking. You may be advised to pause them for a period before surgery. You will also be required to fast from the evening before your surgery.

Recovery

After your surgery, you will be taken to a recovery room for one or two hours while the effects of the anaesthesia wear off. An inpatient stay of some days is usually required after knee replacement. Your doctor will prescribe medications.

You will be given gentle exercises to perform during this time to increase blood flow to your leg muscles and to prevent swelling and clotting. Your doctor may also prescribe blood thinners and a compression boot to protect against swelling and clotting.

On the day after your surgery, your orthopaedic therapist will show you how to exercise in a way that will help your body to adapt to the artificial joint. Physical therapy will then continue for some weeks or months after the procedure. Follow your medical team’s instructions carefully with regard to exercise, activity, diet and care of the surgical area. This will help to ensure a safe and successful adaptation to the new knee.

You may require crutches or a walker for several weeks after your surgery. You may also need some support with regular tasks, so plan for this in advance. If possible, it may be best to arrange to live on one floor of your residence and to install some safety equipment such as bars and handrails.

Clients are usually ready to resume regular activities three to six weeks after surgery. It is usually possible to resume driving after three or four weeks. Even after your recovery is complete, high-impact activities such as jogging or contact sports should be avoided.

Follow your doctor’s advice carefully during your recovery. Your medical team will also provide online monitoring and advice.