Knee replacement surgery in Kent

Knee replacement is generally recommended as a treatment for knee pain that is significantly impacting your quality of life. As well as pain in the knee, patients come to us with knee stiffness and a lack of mobility.

All of these symptoms can make it hard for people to get around as normal and even to perform simple everyday tasks. The leading cause of knee pain is osteoarthritis (wear and tear arthritis), in which the cartilage has gradually worn away, leaving the bones to rub together.

Another is secondary osteoarthritis, where surgery fixed an injury such as a fracture, but the knee joint becomes osteoarthritic over time. The third most common reason is rheumatoid arthritis (RA), which is inflammation of the inner lining of the joints, resulting in chronic joint pain and deterioration of the cartilage and joint. 

One of the primary knee replacement symptoms is pain that reaches 8 or 9 out of 10 in a scale of severity. In addition, the knee stiffens, and the range of movement reduces, affecting the normal function of the knee and impacting activities in your daily life, such as walking, climbing stairs or bending down to pick something up.

When one knee becomes painful, people can put pressure on the other side, but it’s not mandatory to replace that joint as well. Our dedicated consultant orthopaedic surgeons will look at each patient on a case-by-case basis.

Sometimes they will see a combination of issues with one knee and the opposite hip and can provide a treatment plan for both.

How do I know if I need a knee replacement?

The first step is to have what we call an initial consultation. During this appointment, your consultant will see and assess you in the clinic at Chelsfield Park Hospital. They will make and confirm their diagnosis based on a physical examination, your medical history, X-ray and any scans such as an MRI (magnetic resonance imaging).

From this, they will decide whether a knee replacement is the best option for you, or whether another treatment is best. At Chelsfield Park Hospital we offer a wide variety of knee treatments, from non-invasive options such as steroid injections and physiotherapy, to other surgical procedures such as a knee arthroscopy (keyhole surgery).

Every person is different, so we build a bespoke treatment plan for every individual patient. We will only advise knee surgery if we think it’s the best option for you.

Once the consultant has put together your treatment plan, you will have a preoperative anaesthetic assessment to check for any issues affecting or delaying adult knee replacement surgery, such as unforeseen heart problems or hypertension.

On the day of surgery for either partial knee replacement or total knee replacement, your consultant surgeon will confirm your identity, check the site for surgery and confirm your consent. Then, the anaesthetic team will draw up your anaesthetic plan.

In the operating theatre, the anaesthetists will use a general anaesthetic (which means you’ll be asleep for the whole procedure), a spinal block (spinal anaesthetic), or both, depending on what you and the anaesthetist have agreed. If you have a spinal block and not a general anaesthetic, we will give you a sedative too, so you probably won’t remember the operation.

Many people are concerned that not having a general anaesthetic will be a distressing experience, we can reassure you that you will be sedated and comfortable and not at all alarmed by the process.

Once you are anaesthetised, your surgeon will open the knee joint with an incision and shave the femur and tibia to prepare the surfaces, using trial implants (prostheses) to check fit and movement. They will then fit the definitive implants into the joint. The hospital offers custom-made knee replacements created from 3D scans and made with 3D-printed plastic implants.

If you have partial or half-knee replacement surgery, your orthopaedic surgeon will just replace one part of the knee joint. The surgeon will make the skin closure using stitches or surgical staples and keep the wound watertight by adding a waterproof dressing.

They will then send you to a recovery room where the recovery team looks after you before taking you to the ward.

The postoperative recovery period from private knee replacement surgery at Chelsfield Park Hospital is usually 24 to 48 hours, and includes inpatient physiotherapy. The time you will need to stay in hospital varies from person to person, because we don’t want to send you home until you feel – and we feel – that it’s totally safe.

The ward team will give you opioids for the pain and anti-inflammatory medicines to take at home, along with crutches to assist you in moving around, as the aim is to mobilise the joint gently. A nurse will see you for a wound check after two weeks, when they will remove any clips, staples or sutures.

The operating surgeon will see you six weeks after that for a follow-up appointment, but you can ring the hospital for information at any time after your surgery. You will continue physiotherapy as an outpatient for at least three months to keep the knee moving and bending.

After the operation, pain management is vital if you are to get back to an active life. You can support your rehabilitation by taking painkillers regularly, the best being a pack of frozen peas on top of a tea towel, left in place on the knee for 15-20 minutes.

An easy way to remember is to think about peas at every meal and put a pack on the knee while eating. The recovery period for knee replacement surgery is about 12-18 months.

Most people are feeling the benefit of the operation by six weeks. 90% of the recovery happens by six months, but the full recovery can take 12 to 18 months

The recovery period for knee replacement surgery is about 12-18 months.

You can expect to drive after six weeks. In contrast to popular belief the vast majority of total knee replacements will last for 20 to 25 years.

Studies show that satisfaction for knee replacement surgery is about 85%, but 10-15% of patients can continue to experience pain after 18 months post-surgery.

Knee replacement surgery can be more painful than a hip replacement procedure, and it takes time to bounce back, but you must move the knee joint sufficiently during your recovery, even when you’re in pain. Your physiotherapist will visit you when you’re still in hospital and give you a detailed programme of exercises to follow. This will be a bespoke plan tailored to your individual situation.

The more closely you follow the plan, the better your chances of recovery, and the faster you will start to feel better.

In a knee replacement, the wound is at the front of the knee, and it must be constantly stretched to keep it supple. If you yield to the pain and wait for it to go away, rather than working through it, the wound may heal up and the scar contract.

So, if you don’t stretch the scar before it becomes mature, the joint may become stiff, affecting how satisfied you are with the surgery. The success of knee replacement relies on a partnership between the hospital’s surgical team, clinical teams and physiotherapy department and the patient because of the higher risk of joint stiffness and scarring in the knee joint.

As well as joint stiffness, knee surgery risks include pain, bleeding, infection, damaged nerves and vessels, clots of the legs and lungs, and anaesthetic risks. These are the risks associated with any type of surgery.