Knee replacement is the most successful treatment for severe arthritis of the knee. It was developed after hip replacement but essentially does the same thing and it replaces the worn joint surfaces.
It is a very successful operation and approximately 90% of patients get rid of all or most of their pain and back to their original activity level.
The operation is performed in hospital with a stay of four days. The operation is performed under spinal anaesthetic or block with sedation or a light general anaesthetic.
An incision is made down the front of the knee. The worn surfaces of the knee are removed and replaced. A drain in inserted into the knee to prevent haematoma formation and a bulky dressing is placed on the knee. These are removed the next day.
The day after the operation the physiotherapists mobilise the patient with crutches.
By four days the patient can normally get in and out of bed themselves, walk around the corridors and do the stairs when they are ready to go home.
The surgical clips are removed by the District Nurse ten days following the operation and a daily exercise programme is recommended together with physiotherapy in order to strengthen the muscles and regain the range of movement and strength of the knee.
Patients can return to driving at six weeks and sport such as golf at twelve weeks. This is a major but safe and successful procedure. Any operation involving an anaesthetic involves a small risk to a patient’s life and to medical complications and therefore prior to admission to hospital the patient has a full medical, risk of infection is reduced by the use of anaesthetics and performing the operation in a special lamina flow filtered air theatre, the operation is done from the front of the knee away from blood vessels and nerves, and it is rare for damage to these to occur, prophylaxis to prevent DVT is given in hospital in the form of special boots on the feet and injection. On discharge a two week course of tablets is given to thin the blood. Stiffness can be a problem after knee replacement and the patient therefore receives active physiotherapy in hospital as well as after discharge.
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