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Knee replacement FAQs

If your knee pain is interfering with your mobility, sleep and overall quality of life, you could be advised to have knee replacement surgery. More than 70,000 knee replacements are performed every year in England and Wales with osteoarthritis being the most common reason for having knee replacement surgery. You might also choose to have a knee replacement following a knee injury or due to a deformity in your knee. 

Consultant knee, hip and sports injury specialist, Mr Nadim Aslam at BMI The Droitwich Spa Hospital responds to commonly asked questions about having knee replacement surgery, including what the procedure could involve and what to expect during your recovery period. 

Mr Nadim Aslam: A package deal which includes the cost of your surgery, prosthesis, anaesthesia, three days of hospital stay and medication can cost between £12,000 to £15,000. The average cost of having knee replacement surgery is about £12,500.

Mr Nadim Aslam: In most cases, a knee replacement operation can take between 60 to 90 minutes. The anaesthetic and recovery time can take up to an hour. 

Mr Nadim Aslam: Modern day knee replacements should last at least 15 to 20 years. The materials used to create modern knee replacements are better and their wear properties have improved.

However, the longevity of your knee replacement also depends on how active you are and your age.  

Mr Nadim Aslam: Enhanced recovery pathways mean your hospital stay can range from one to three days.

Mr Nadim Aslam: Knee replacements are usually painful and swollen during the first few weeks following your operation. It is advised that you do not carry out any excessive activity and try to keep your leg in an elevated position.

We usually recommend rest and using ice packs during the first few days after your operation to help manage pain and minimise any swelling.

Your wound must be kept clean — it is important that you avoid removing or soaking the dressing. The stockings that your Consultant will provide with should also be kept on for 6 weeks. They will encourage the early movement of your calf to reduce your risk of developing a blood clot.

Mr Nadim Aslam: Your knee arthritic pain will improve within a few days after your operation. But pain from the location of your surgery will continue for about six to 12 weeks.

We allow you to walk on the day of your surgery and crutches are generally phased out over a period of four to six weeks. At six weeks, most patients are able to walk comfortably with the occasional support of a walking aid such as a walking stick.

Your recovery also depends on a few other factors, including how active you were before your surgery, your age, any preexisting medical conditions, and other health and lifestyle factors.

Mr Nadim Aslam: Patients are often reluctant to kneel due to scar sensitivity or stiffness but it is possible to kneel and it will not cause any harm. We recommend initially kneeling on soft surfaces and if your scar is sensitive, a knee pad can be used.

Mr Nadim Aslam: Knee replacements will allow you to run; however, impact loading or running on a hard surface can increase the wear rate of the knee and cause your knee replacement to loosen. You should wait about six weeks before returning to any high impact contact sports.

It is advised that you wait about four to six weeks before going swimming, which will give your incision time to completely heal. You will be allowed to participate in leisure activities such as tennis, golf and increased gym exercise six weeks after your operation.

Mr Nadim Aslam: Your knee joint is more complex and sensitive than your hip joint. It can feel painful during the first four to six weeks following your operation. But after about six to 12 weeks you will usually experience an improvement in your pain.

Mr Nadim Aslam: Walking will be restricted by the pain and swelling that will occur after a knee replacement. The implants will allow you to fully weight bear from the outset. For the first two weeks, your recovery will be focused on reducing any pain and swelling to allow an increased range of motion. You can gradually increase your walking distance; however, it usually takes about four to six weeks before you can walk a reasonable amount of steps.

Mr Nadim Aslam: The first four to six weeks can be very painful and your movement gradually improves as the swelling reduces. We usually see a considerable improvement in the pain and swelling between six to 12 weeks. While the majority of patients do well after a knee replacement, 20% of patients are dissatisfied. This may be due to stiffness, residual pain or a complication.

Mr Nadim Aslam: It is possible to kneel down on your knee but you might find it more comfortable to begin kneeling with knee pads. It is possible to flex the knee past 90 degrees and you can maintain any comfortable position to get onto or off the floor.

Mr Nadim Aslam: You can keep your knee replacement in a comfortable position while sleeping. There is no risk of dislocation of the joint or requirement to keep your knee in a particular position.

Mr Nadim Aslam: Your knee will feel uncomfortable for six weeks. There is a significant improvement between six to 12 weeks in pain and how your knee function. After about three to six months, you will be less aware of the replacement and your recovery will have advanced. Your knee will continue to improve over a 24-month period following your surgery.

Mr Nadim AslamKnee replacements consist of three components: the femoral (thigh bone) component, the tibial (shin bone) component that has a polyethylene spacer and the patella (knee cap) which can be resurfaced in certain cases with a button. These components are made of metallic alloys and in some cases, titanium can be used. The liners and the patella resurfacing button are formed of highly crosslinked polyethylene.

Mr Nadim Aslam: It is possible to perform bilateral knee replacements. However, this is associated with a increased risk of medical and surgical complications and it is therefore typically not recommended.

Mr Nadim Aslam: A partial knee replacement is when only one compartment of the knee is replaced. This is usually the medial (inner) compartment of your knee or your patellofemoral (knee cap) compartment.

Partial knee replacement surgery is associated with less pain and an enhanced recovery. When compared to a total knee replacement, a partial knee replacement is better at preserving a range of motion and function in the knee as it preserves healthy tissue and bone in your knee. Patients therefore tend to be more satisfied following partial knee replacement surgery,

Mr Nadim Aslam: Knee replacements can be carried out in patients who are overweight. But a BMI that is above 40 is associated with a higher risk of medical and surgical complications. As a result, patients are usually advised to their improve their fitness and keep their BMI to below 40.

Mr Nadim Aslam: Knee replacements can be carried out with a pacemaker. During your preoperative assessment, your pacemaker needs to be fully assessed. We try to use a bipolar diathermy (where an electrical current is passed through the body) to minimise the amount of current that passed through your body.

Mr Nadim Aslam: Knee replacement is only recommended, if you have severe pain and your quality of life has become very limited. Your radiographs might show that your knee joint has completely worn out. 

Prior to be considered for surgery, you would have usually tried all conservative treatment including painkillers and physiotherapy

Mr Nadim Aslam: Most people do very well with their knee replacement. But as with any surgery, the procedure does carry some risks. The possible complications of this surgery include: infection, excess bleeding, blood clots, injury to nearby nerves and blood vessels, dislocation of mobile bearing, residual pain and loosening of the knee joint.
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