Knee Replacement Surgery: The Procedure and Your Recovery

Knee replacement surgery involves removing damaged bone, and cartilage and replacing them with an artificial joint. This video explains what happens during the procedure, the surgical risks involved, and what you can expect during your recovery. During knee replacement surgery, all or part of your joint may be replaced depending on the extent of damage. Diseased bone and cartilage are removed and replaced with a prosthesis made from metal and polyethylene - a strong, medical-grade plastic. The choice of prosthesis depends on your age, bone quality, ligament condition, and activity level. The surgical approach depends on whether you are having a total or partial knee replacement. For total knee replacement, or patellofemoral replacement, an incision is made in the midline at the front of your knee. For partial replacement, the incision may be to one side of the midline. The worn cartilage and damaged bone are then carefully removed. The bone surfaces are prepared to receive your new joint components. Metal parts are typically fixed to the thighbone and shinbone using special bone cement, with a plastic insert placed between them. A plastic component may also be attached to the back of the kneecap. Before the incision is made, antibiotics are given to reduce infection risk, and medication is administered to reduce bleeding. A tourniquet - a band that temporarily compresses blood vessels - is applied to the thigh and may remain in place for part or all of the surgery. The surgery typically takes between one and two hours and may be assisted by a robotic device for greater precision. Whether robotic assistance is appropriate for you will be discussed and agreed before your operation. Prior to wound closure, a pain relieving cocktail is infiltrated from your bone to skin, to improve post operative pain. This will be supplemented by oral and intravenous painkillers. Hospital stay is typically one to two nights. Exercises usually commence on the day of surgery if possible - success from knee replacement surgery depends on early movement. You will begin mobilising with support from physiotherapy staff and receive supervised progression from a walking frame to a stick, and then to independent walking as appropriate. Recovery timeframes vary depending on the procedure performed and your pre-operative function. For total knee replacement, full recovery typically takes around three months. For partial knee replacement, recovery is usually quicker, approximately eight weeks on average. As with any surgery, knee replacement carries some risks. These include infection, blood clots in the leg or lungs, injury to ligaments, tendons, nerves, or blood vessels, and fracture. Also, some numbness around the scar is common. Hair removal should be carried out just prior to surgery to reduce risk of infection. You will usually be advised to avoid kneeling on your knee for at least three months to prevent irritation, wound healing problems, or infection. Driving can typically resume once you can bend your knee beyond ninety degrees and perform an emergency stop safely. Regular physiotherapy exercises will help strengthen your muscles. At two weeks after surgery, your GP, practice nurse, or occasionally a hospital nurse, will inspect your wound. Please leave the dressing intact until this appointment. A dissolvable stitch is used, so no stitches need to be removed after surgery. Your first follow-up with me is at six weeks after surgery, with further appointments at three months and beyond as needed. The NHS website and Patient.info offer helpful guidance on recovery. For personalised advice, please contact my secretary Maya Rahman.