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Stopping knee pain: when should I consider knee replacement surgery?

Knee pain is exceedingly common and can become debilitating. It can stop you doing simple everyday activities like bathing or walking around the home and can make sleeping difficult. If knee pain is stopping you from living life to the full, knee replacement surgery could be an option.


What is causing the pain?

If you are considering knee replacement surgery it can help to understand what is causing your knee pain. Most people who have a total knee replacement are over 65 years old and in 98% of cases the pain is caused by osteoarthritis, although sports injury and rheumatoid arthritis can also result in the need for surgery.



Causes of knee pain: Natural wear and tear

Walking, bending, jumping, running: over a lifetime, your knees have to withstand a lot of action. Normally the body can naturally repair itself, but in some cases it can’t, ultimately leading to osteoarthritis.


Osteoarthritis is also sometimes known as wear and tear arthritis. In a healthy joint the cartilage (the natural cushioning in your joints) protects the bone ends and keeps them working smoothly. In a joint with osteoarthritis the cartilage has worn away so the bone ends in the joint rub against each other, causing pain, stiffness and reduced mobility. In some case this friction can also cause bone spurs to form. If you’re a keen sportsperson or carrying extra weight, this damage to your joints can be accelerated.

Who needs knee replacement surgery?

Whilst knee pain is common, it does not always mean you need to have surgery. Painkillers, corticosteroid injections and physiotherapy can be very effective in managing pain and increasing your mobility. However, these alternatives do become less effective as osteoarthritis progresses, so don’t put off getting advice and treatment. If these treatments don’t work for you, and the pain makes even the simplest tasks like walking up and down stairs difficult. Also if it interferes with your sleep, then knee replacement surgery could be an option.




Your consultant may be able to diagnose what is causing your pain by using a physical examination or a magnetic scan (MRI scan). Key-hole surgery allows your surgeon to see inside the knee by inserting a tiny camera through a small incision. Your surgeon can use this technique to identify the cause of pain, and in some cases correct it without the need for a replacement knee operation.



What is knee replacement surgery?

Knee replacement surgery is a routine operation that involves replacing a damaged, worn or diseased knee with an artificial joint. It’s a very common procedure, with over 90,000 knee replacements carried out in the UK in 2012. It usually takes between an hour and an hour and a half and you should be able to go home around four to seven days after the operation.


During the operation your surgeon will remove the damaged surfaces at the ends of your thigh and shin bones. These ends will then be replaced with plastic, ceramic or metal parts, which act like the lost cartilage and make movement easier. The kneecap can also be resurfaced and replaced. An acrylic cement will be used to attach the new parts to your bone.

Depending on the condition of your knee you may need a total knee replacement, where both sides of your knee joint are replaced or a partial (half) knee replacement, where only one side is replaced.

After surgery you should experience a lot less pain in your knee and find walking and performing simple tasks a lot easier.


Risk versus benefits

Although knee replacement surgery has a 99% success rate it is still a major operation, so it’s important to carefully consider whether you really need it. Speak to your doctor and watch this video where Consultant Orthopaedic Surgeon Mr Howard Ware from BMI The King's Oak and Cavell Hospitals, discusses when to consider knee replacement surgery.

Pain can be very subjective and it’s important to think over how the pain you experience affects you and your overall quality of life. It’s also worth bearing in mind that as well as dealing with the pain itself, if you feel it is holding you back from enjoying life it can have a big impact on your mental health and wellbeing.

Just like any major operation there are certain risks to be weighed up against the benefits, including pain, blood clots and infections. There are also some specific slight risks associated with knee replacement surgery, including damage to nerves and blood vessels, knee infection and severe pain, stiffness and the loss of use of the knee (Complex Regional Pain Syndrome).


Don’t let knee pain stop you

Your BMI Healthcare consultant can discuss all the pros and cons of knee replacement surgery with you to help you to make an informed decision and get back to living life to the full, sooner. They can advise you on all the treatment options available and if you do decide to opt for surgery, they will help you to understand exactly what to expect.


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