Knee replacement surgery
Total knee replacement surgery replaces the natural joint surfaces of the knee with artificial ones. It is most commonly needed because of damage done to the joint by a degenerative disease like osteoarthritis, but there are other rarer causes, including osteonecrosis, where the bones lose their blood supply and crumble away, and inflammatory arthritis, such as rheumatoid arthritis or psoriatic arthritis.
The new artificial knee joint removes the pain and stiffness that was being caused by the degenerative disease, and it really can make a significant difference very quickly to quality of life.
I carry out around 100-150 knee replacements a year, and you can review data from my operations on the National Joint Registry website as this can be a helpful resource when choosing a surgeon.
When people first come to see me, they tend to complain of chronic, worsening knee pain. This pain is often troublesome and affects them standing or walking. As the degenerative disease progresses, the pain can begin to hurt when sitting still or in bed at night. Certainly, if it's hurting them in bed at night and disturbing their sleep, that is often a strong indicator that surgery on the knee may be required.
Not all knee pain will require a knee replacement to resolve, but it can be helpful to be aware of the things to look out for.
By the time I see somebody, they will usually have already had an X-ray of their knee, usually arranged by their GP. This X-ray can be helpful, as it may show evidence that it actually is degenerative arthritis that is causing the knee pain. If they haven’t previously had an X-ray, I’ll arrange for them to have one at the end of the consultation and then I’ll see them again a short time later with the benefit of that up-to-date X-ray.
I will talk with them about their symptoms as well as their general health. I’ll then explain how knee replacement surgery is carried out, what risks are involved and what they should expect for their recovery.
Before any surgery, it is important a person has all the information needed to make an informed decision, and I will always make sure that we talk through any questions they may have. The decision to have surgery is always the patients to make.
I always warn people that knee replacement surgery is quite an uncomfortable operation to have, certainly in the early stages of recovery. While we work really hard to get the correct dose for painkillers to keep them as comfortable as possible after surgery, it's absolutely vital that they push on with their exercises and to keep the joint moving, as the people who move it the most get the best outcome. Our Circle physiotherapy team will help show you the exercises and movement to do, as you need to build strength and function in the new joint sensibly over time.
While there are a range of options available, the prosthesis I use is called the Triathlon knee, made by Stryker. It gives really good results. When I started using it, around 9 years ago, I noticed that my patients were just doing better with the Triathlon. (Really interestingly, every single person I saw who had a different prosthesis in one knee and a Triathlon in the other preferred the Triathlon, so I am very confident offering it to patients.)
I see private patients back in clinic at 6 and 12 weeks to check their recovery. Usually by 3 months, many people are feeling really good. Recovery times vary for each person, but people are certainly noticing significant improvements within two weeks. At the 6-week stage, most are as good or better than they were with their arthritis. Within 3 months, most people are feeling really good. Talking with them at this stage I find that many of them have booked a foreign holiday, just to celebrate being better and out of their chronic knee pain.
Knee replacement is a very good operation, one that can make a significant difference to people’s lives. It can take them out of pain and restore movement, function and mobility to the knee. Seeing the results this surgery gives to my patients is incredibly fulfilling for me; it is actually the favourite part of my job.
Should you have pain in your knee, please do contact Circle to book a consultation with me. When we meet, I will discuss and arrange any diagnostic tests needed to determine exactly what is causing your pain. If a knee replacement is indicated to successfully treat the problem, we can arrange that for you without any unnecessary delay.