Overview

This operation is for the management of arthritis of the knee joint.

It involves removing the damaged surfaces of the knee and replacing them with an artificial joint. The artificial joint is made up of two metal components and a specialised plastic liner.

The aim is to replace the knee that is painful, stiff and often deformed with one that is pain-free, mobile and better aligned.

The operation

  1. This is usually done under general anaesthetic.
  2. This operation takes approximately 60-75min.
  3. A cut is made over the front of your knee.
  4. The bottom end of your thigh bone (femur) is cut to remove the damaged surface and the metal part of the artificial joint is fitted.
  5. The damaged end at the top of your shin bone (tibia) is removed and the other metal part of the artificial joint is fitted.
  6. The specialised plastic liner is then inserted onto the metal component on the tibia.
  7. The joint is then tested to make sure everything fits well and is aligned.
  8. The wound is then closed using stitches and covered using a large dressing.

Occasionally may need a blood transfusion due to blood loss during this operation.

After the operation

  • Pain relief – good pain relief is important and you will be given this during and after your procedure. Some people need more than others so please inform the nursing staff if you are in any discomfort following your procedure.
  • Hospital stay is usually 1-3 days.
  • Physical activities – you will start to put weight on the knee with support from a frame or crutches from the day of your surgery. Usually by 6 weeks you would be able to walk independently or down to using one crutch.
  • Swelling and bruising may take up to 8-12 weeks to improve.
  • Showering and bathing – you need to keep your wound well covered using the waterproof dressing provided whilst showering. When bathing do not submerse wound in water as dressing are not designed to withstand this. This is important until the wound is healed and stitches have been removed.
  • Do not remain in one position for too long whilst in bed to prevent sores on your back, heels, ankles and to also reduce the risk of developing deep vein thrombosis.
  • Increase activity with each day. You will notice most improvement in the first 3 months but can expect further improvement up to 12 to 18 months as your muscle become stronger.

Your surgeon and physiotherapist will discuss with you issues surrounding:

  • Returning to work
  • Using your knee following your operation
  • Driving
  • Anticipated length of rehabilitation

Possible complications

All surgery has associated risks. These risks are higher in some patients than others. Risks include:

  • Anaesthetic – your anaesthetist will discuss risks associated with the anaesthetic with you.
  • Infection – there is a very small risk of wound infection following your operation that is minimised by giving you antibiotics. If at any time you notice a fever or increased pain, swelling or redness around you wound, please contact us urgently. Rarely patients may require to return to theatre for further surgery and/or be placed on prolonged course of antibiotics.
  • Bleeding – this can sometimes occur after surgery and if severe may require a return to theatre.
  • Deep vein thrombosis – this is a blood clot in the leg. You will be given blood thinning medication and support stocking to help prevent this. If you notice a pain in your calf then please seek immediate medical attention.
  • Pulmonary embolism – this is a blood clot in your lungs. You will be given blood thinning medication to help prevent this. If you notice a sharp pain in your chest or shortness of breath then please seek immediate medical attention.
  • Loosening – your new knee may eventually become loose or wear out over time. This will need to be replaced depending on your level of symptoms.
  • Numbness – there is typically numbness on the outer side of the knee. This is because some small skin nerves are cut during the operation. Some but not all of this sensation should return. Numbness should not stop you from kneeling, however, patients often report that kneeling can be difficult following surgery.

Please notify your surgeon if undergoing any other operations, hospital examinations, dental work or if you have an infection before your scheduled operation. Your operation may have to be deferred to reduce the risk of developing a deep infection of your artificial joint. If you are unsure please discuss this with your surgeon.