Knee replacement surgery

You may need a knee replacement at any age, however, getting older increases your risk — those aged between 60 and 80 are most likely to need a knee replacement. Genetics, previous knee injury and lifestyle can also play a part in whether you need a knee replacement, so always seek medical advice if you have symptoms.

Your doctor may recommend knee replacement if:

• You find it difficult carrying out everyday tasks
• You have depression due to pain or reduced mobility
• Your mobility is reduced
• Your quality of life is impacted, including your sleeping
• You’re unable to work or socialise

Knee replacement surgery can relieve pain and help you become more active again. However, you must be healthy enough to undergo surgery.

Your consultant may suggest an alternative to knee replacement, although the results may not last as long. These treatments are often performed using arthroscopy — a type of keyhole surgery using a thin, flexible, telescopic instrument called an arthroscope.

Knee replacement alternatives include:

• Arthroscopic washout – flushing the knee joint with fluid using keyhole surgery, often performed with debridement (removal of loose bone or cartilage); this is less common than it used to be
• Ligament surgery to reconstruct damaged ligaments
• Microfracture – your surgeon makes small holes in your bones to stimulate cartilage growth
• Mosaicplasty – transferring healthy cartilage taken from the edge of your joint to the damaged area
• Osteotomy – the shin bone is cut and realigned to reduce the weight carried by the damaged part of your knee

Your doctor will usually only recommend surgery after you’ve tried other non-invasive alternatives to knee replacement without success. Other treatments include:

• Lifestyle changes
• Medications
• Physiotherapy
• Steroid injections

Your surgery will be performed by your consultant surgeon.

You’ll be helped out of bed to stand around 12 to 24 hours after your operation. You can then walk with a frame or crutches and should be able to do so independently after a week. If you’ve had keyhole surgery or are on an enhanced recovery programme, it may be sooner.

A physiotherapist will show you some exercises you can do to help strengthen your knee that you can start the day after surgery.

It can take up to two years for your knee to recover, however, you should be able to resume normal daily activities within six weeks and any pain and swelling should settle within three months. Your leg may be swollen for up to a year.

You’ll return to hospital a few weeks after your operation for a follow-up appointment to check your recovery progress.

For most people, their new knee lasts around 20 years or even longer for total knee replacement. Partial knee replacements tend to need to be replaced sooner – after around 10 years. The chances of needing a repeat operation is higher if you’re overweight, you run, play vigorous sports or you conduct heavy manual work.

You should gradually build up any activity, and should be able to manage walking or swimming around six to eight weeks after surgery, depending how fit you were before surgery. You should avoid high impact sports such as running, contact sports or weight lifting. Your consultant or physiotherapist will be able to advise which sports you can do, they may recommend avoiding tennis, squash and skiing, but cycling, dancing and golf may be fine.

Preparing for your surgery by being as fit as possible and strengthening your knee muscles will help improve your recovery time. Before your operation, it’s also a good idea to prepare your home to make it easier for you to get around safely and more easily. Remove anything you can trip over and make sure important items are easy to reach.

For the first few days or weeks at home, you may need someone to help you with errands and household chores.

Speak to your consultant or GP before flying to find out what’s right for you. It’s important to note that your chance of deep vein thrombosis (DVT) increases if you fly after recent surgery.

Airlines have their own regulations about passengers flying after surgery, so make sure you check beforehand.

Knee implants are made from high-grade plastics, polymers and metal alloys.

There are several different metals commonly used in knee replacements, specifically cobalt-chromium, nickel, titanium and zirconium.

Yes, both knees can be replaced at the same time. This may be recommended if you have osteoarthritis in both knees. However, the surgery and recovery time are longer — you will also need more support during your recovery.

Yes, you can have a knee replacement if you are overweight. However, being overweight puts you at greater risk of certain complications during and after surgery. Your doctor will discuss the benefits and risks of knee replacement surgery in your particular case with you so you can make an informed decision.