Our expert orthopaedic surgeons can help. Previous Next. View Larger Image. This common procedure can help reduce pain and restore your ability to move better. Partial knee replacements can be carried out through a smaller cut incision than a total knee replacement, using techniques called reduced invasive or minimally invasive surgery. A smaller incision may further reduce the recovery time.
Research shows that people who have partial knee replacements are more likely to have the knee revised than people who have a total knee replacement — about 1 person in 10 needs further surgery after 10 years. Even though the operation involves less interference with the knee it is often a more complex operation than total knee replacement.
Your surgeon may therefore prefer to offer you a more predictable total knee replacement. Partial knee replacement can be considered at any age. For younger people, it offers the opportunity to preserve more bone, which is helpful if you need revision surgery at a later stage. For older people, partial knee replacement is a less stressful operation with less pain and less risk of bleeding. The outcome of the surgery, however, depends on the type of arthritis, rather than your age.
A kneecap replacement involves replacing just the under-surface of the kneecap and its groove the trochlea if these are the only parts affected by arthritis. It's possible to replace just the under-surface of the kneecap and its groove the trochlea if these are the only parts affected by arthritis.
This is also called a patellofemoral replacement or patellofemoral joint arthroplasty. The operation has a higher rate of failure than total knee replacement — which may be caused by the arthritis progressing to other parts of your knee. Some surgeons advise a total knee replacement as the results are more predictable. The operation is only suitable for about 1 in 40 people with osteoarthritis.
More research is needed to understand which people are likely to do well with this operation. A complex knee replacement may be needed if you're having a second or third joint replacement in the same knee, or if your arthritis is very severe. These knee replacements usually have a longer stem, which allows the component to be more securely fixed into the bone cavity. The components may also interlock in the centre of the knee to form a hinge to give greater stability.
Research has shown that four out of five people who've had knee replacement surgery are happy with their new knees. For those people who aren't happy, the main cause for dissatisfaction is continuing pain which may not be due to a problem with the operation. This is more of a risk if you have relatively minor joint damage which may still cause severe symptoms before surgery. If your joint damage isn't very severe it may be better to carry on with non-surgical treatments rather than risk a poor outcome from surgery.
Possible disadvantages of knee replacement surgery can include replacement joints wearing out over time, difficulties with some movements and numbness. We now know that knee replacements aren't so likely to be effective in the early stages of arthritis.
We can be much more confident of a good outcome where the arthritis is more advanced. Most knee replacements will last for 20 years or more, so younger patients are more likely to need a repeat knee operation at some point in later life. The chances of needing repeat surgery are increased if:. Although your knee can be replaced again if necessary, revision surgery is more complicated and the benefits tend to lessen with each revision.
Most doctors recommend non-surgical conservative treatments before considering a knee replacement. These include:. Keyhole surgery techniques arthroscopy to smooth damaged cartilage and remove debris from the knee joint can only be used in very specific circumstances. If there are mechanical symptoms such as 'locking' of the knee then removing loose fragments of bone and cartilage may avoid having to have a knee replacement at that stage.
There's no evidence that it's of benefit for arthritis generally. This operation, which is performed by keyhole surgery, involves making holes in exposed bone surfaces with a drill or pick. This encourages new cartilage to grow from the bone marrow. This is an operation which may help younger patients. It involves cutting the shin bone crosswise, creating a wedge to shift the load away from the area affected by arthritis.
Osteotomy may be considered as a way of putting off a knee replacement operation. However, it can make it more difficult to carry out a successful total knee replacement later on — especially if during the osteotomy the surgeon has to cut through the medial collateral ligament at the inner surface of the knee.
Rarely, if the outer part of the knee is affected by arthritis, this operation is performed on the end of the thigh bone to shift load inwards. If only the hard cartilage is damaged, new cartilage can be grown in a test tube from your own cells. The new cartilage is then applied to the damaged area.
This technique is mainly designed to repair small areas of cartilage damage resulting from accidental injury to the knee joint. It's usually therefore only done as part of a research trial, as are newer techniques using stem cells. We explain which foods are most likely to help and how to lose weight if you need to. In England, our NHS right to treatment within 18 weeks is at risk.
Visit our campaign page to learn more. It's a good idea to make sure your general health is as good as it can be before your operation, for example if you have other health problems such as diabetes or high blood pressure. Your orthopaedic surgeon will probably suggest exercises to strengthen the muscles at the front of your thigh quadriceps , which often become weak with arthritis.
The stronger these muscles are before surgery, the quicker your recovery is likely to be. Exercises that involve raising your foot against gravity are best. You'll probably be invited to a pre-admission clinic a few weeks before surgery. This may include the following tests:. You should also discuss with your surgeon, anaesthetist or nurse whether you should stop taking any of your medications or make any changes to the dosage or timings before you have your surgery.
Different units may have different views. Start planning for your return home and recovery arrangements. It's important to ask any questions you may still have at this stage. Your knee will then be marked for the operation. You'll be asked if you're willing for details of your operation to be entered into the National Joint Registry NJR database. The NJR collects data on hip and knee replacements in order to monitor the performance of joint implants. It is only by measuring the outcomes of all knee replacements that we can learn what works best and for which patients.
If you're taking drugs that affect blood clotting, such as warfarin and clopidogrel, you should follow instructions to prevent too much bleeding during and after surgery. You'll probably be given a sedative medication a pre-med while waiting in the admission ward. Most knee replacements are now done under either a spinal or an epidural anaesthetic. These numb the body from the waist down, but you'll remain awake throughout the operation. If you have a general anaesthetic instead, you may also be given a nerve block — this will block pain in your leg for up to 36 hours after surgery but will also weaken the leg temporarily.
Many surgeons instead inject a type of local anaesthetic into the tissues around the knee during the operation to numb the pain but still allow the muscles to work so you can get up sooner after the operation.
If you can, continue to do gentle exercise, such as walking and swimming, in the weeks and months before your operation. You can be referred to a physiotherapist, who will give you helpful exercises. Read about preparing for surgery , including information on travel arrangements, what to bring with you and attending a pre-operative assessment.
Once you're able to be discharged, your hospital will give you advice about looking after your knee at home. You'll need to use a frame or crutches at first and a physiotherapist will teach you exercises to help strengthen your knee. Most people can stop using walking aids around 6 weeks after surgery, and start driving after 6 to 8 weeks. Full recovery can take up to 2 years as scar tissue heals and your muscles are restored by exercise. A very small amount of people will continue to have some pain after 2 years.
Knee replacement surgery is a common operation and most people do not have complications. However, as with any operation, there are risks as well as benefits.
There is also a slight risk of serious complications. The risk of death in a healthy person having routine surgery is very small. Death occurs in around one in every , general anaesthetics given. The risk is higher if you are older or have other health conditions, such as heart or lung disease. Your anaesthetist and surgeon can answer questions you may have about your personal risks from anaesthetic or the surgery itself.
Complications occur in about 1 in 20 cases, but most are minor and can be successfully treated. Possible complications are described below. Wear and tear through everyday use means your replacement knee will not last forever. However, for most people it will last at least years, especially if cared for properly and not put under too much strain. Revision knee replacement surgery replacing the replacement knee is usually more complicated and a longer procedure than the original surgery.
There is no set limit to the number of times you can have revision surgery, but it is widely accepted the artificial knee joint becomes less effective each time it is replaced. Recovery times can vary depending on the individual and type of surgery carried out.
It is important to follow advice the hospital gives you on looking after your knee. In the surgical ward, you may be given a switch that enables you to self-administer painkillers at a safe rate.
You may also be given oxygen through a mask or tubes. If necessary, you will be given a blood transfusion. You will have a large dressing on your knee to protect your wound.
Various drains will syphon off blood from the operation site to prevent it collecting inside the wound. The staff will help you to get up and walk about as quickly as possible. If you have had minimally invasive surgery or are on an enhanced recovery programme, you may be able to walk on the same day as your operation. Generally, you will be helped to stand within hours after your operation. Walking with a frame or crutches is encouraged. Most people are able to walk independently with sticks after about a week but this can vary depending on the individual.
During your stay in hospital, a physiotherapist will teach you exercises to help strengthen your knee. You can usually begin these the day after your operation. It is important to follow the physiotherapist's advice to avoid complications or dislocation of your new joint. It is normal to experience initial discomfort while walking and exercising, and your legs and feet may be swollen.
You may be put on a passive motion machine to restore movement in your knee and leg. This support will slowly move your knee while you are in bed. It helps to decrease swelling by keeping your leg raised and helps improve your circulation.
You will usually be in hospital for 3 to 5 days, depending on what progress you make and what type of knee replacement you have. Patients who have a half knee replacement usually have a shorter hospital stay. If you are generally fit and well, the surgeon may suggest an enhanced recovery programme where you start walking on the day of the operation and are discharged within 1 to 3 days.
Do not be surprised if you feel extremely tired at first. You have had a major operation and muscles and tissues surrounding your new knee will take time to heal.
Follow the advice of the surgical team and call your GP if you have any particular worries or queries. You may be eligible for home help and there may be aids that can help you. You may also want to arrange for someone to help you out for a week or so. The exercises your physiotherapist gives you are an important part of your recovery.
It is essential you continue with them once you are at home. Your rehabilitation will be monitored by a physiotherapist. You should be able to stop using your crutches or walking frame and resume normal leisure activities 6 weeks after surgery.
However, it may take up to 3 months for pain and swelling to settle down. It can take up to a year for any leg swelling to disappear. Your new knee will continue to recover up to 2 years after your operation.
During this time, scar tissue will heal and muscles will be restored by exercise. Even after you have recovered, it is best to avoid extreme movements or sports where there is a risk of falling, such as skiing or mountain biking.
Your doctor or a physiotherapist can advise you. You can resume driving when you can bend your knee enough to get in and out of a car and control the car properly. This is usually around 4 to 6 weeks after your surgery, but check with your physiotherapist or doctor whether it is safe for you to drive. For the first 3 months, you should be able to manage light chores, such as dusting and washing up. Avoid heavy household tasks such as vacuuming and changing the beds. Do not stand for long periods as this may cause ankle swelling and avoid stretching up or bending down for the first 6 weeks.
You may find that having the operation gives your sex life a boost. Your surgeon can advise when you can have sex again. As long as you are careful, it should be fine after 6 to 8 weeks. Avoid vigorous sex and kneeling positions. You will be given an outpatient appointment to check on your progress, usually 6 to 12 weeks after your knee replacement.
The knee can be replaced as often as necessary, although results tend to be slightly less effective each time. Recovery may take longer, but once you have recovered, results are usually good.
Home Tests and treatments Surgical procedures Knee replacement. Knee replacement See all parts of this guide Hide guide parts 1. Introduction 2. Why it's necessary 3.
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