Knee Surgeon
Total knee replacement
What is a total knee replacement?
Knee replacement surgery is a treatment option for people with arthritis who experience severe pain that affects their quality of life and limits knee function.
During a total knee replacement, all three compartments of the knee are resurfaced using artificial components. This procedure has a high success rate; however, it is important to have realistic expectations. A knee replacement will not restore the full range of motion or function you had before your knee problems began.
The main goals of the surgery are to:
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Significantly relieve knee pain
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Improve mobility (your ability to get around)
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Help you return to everyday activities
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If non-surgical treatments such as pain-relief medication, physiotherapy, or lifestyle changes are no longer effective, a total knee replacement may be considered.
In up to 50% of patients, arthritis affects only one compartment of the knee. In these cases, a partial knee replacement may be a suitable option.
What is involved in a total knee replacement?
Steps of a total knee replacement:
1. Anaesthetic
The surgery can be performed under either a general or spinal anaesthetic.
2. Skin incision and deeper dissection
A vertical incision is made through the skin over the front (anterior aspect) of the knee. The joint capsule is then incised to allow access to the knee joint.
3. Preparation of bony surfaces
Cutting jigs and a bone saw are used to remove the diseased joint surfaces. The bone surfaces are prepared to receive the appropriately sized femoral component, tibial component with a polyethylene plastic liner, and a patella button. The components are carefully sized and positioned to achieve the best possible alignment and fit for your knee.
Trial components are inserted to check that the knee moves through a satisfactory range of motion and that the ligaments are balanced correctly.
4. Component implantation
The femoral component, tibial component, and patella button are fixed in place using acrylic bone cement. A polyethylene plastic liner is then securely attached to the tibial component.
5. Wound closure
Local anaesthetic is injected into the soft tissues around the knee to help with pain relief after the operation and to support early mobilisation. The soft tissue layers that were incised to access the knee are closed in layers using dissolvable sutures. The skin is closed with a buried dissolvable suture and sealed with wound glue. A waterproof dressing is applied over the wound.
Finally, the knee is wrapped with a layer of wool and a crepe bandage, which helps reduce internal bleeding. The operation typically takes around 60–90 minutes, depending on its complexity.
Post operative care
Once the operation has been completed, you will be transferred back to the ward, where the team will continue to monitor you closely. Although this is a painful procedure, strong pain relief and an ice cuff applied to the knee are used to help keep you comfortable. Most patients can stand and begin gentle mobilisation on the same day as the surgery, with the support of mobility aids if needed.
A physiotherapist will see you after the operation and guide you on how to move safely and confidently. An X-ray of your knee will be performed to confirm that the knee replacement is in the correct position.
Your discharge from hospital will depend on:
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Successfully completing a physiotherapy assessment to ensure you can mobilise safely
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Your pain being well controlled
More than half of patients are able to return home safely the day after surgery, after spending one night in hospital.
Recovery and rehabilitation
Recovery times can vary between individuals. Physiotherapy will guide you through each stage of your rehabilitation. Completing your rehabilitation exercises is very important to help prevent knee stiffness and to allow your knee replacement to reach its best possible outcome.
Early recovery (Weeks 1–2)
The focus is on pain control, using ice and elevation to reduce swelling. You will begin gentle muscle-activation exercises and start working on knee range of motion.
Functional recovery (Weeks 2–6)
Pain continues to improve during this stage. Exercises focus on increasing knee range of motion to help the knee straighten and bend as much as possible. You will also gain confidence with walking and everyday activities.
Strength and endurance (Weeks 6–12)
You will continue range-of-motion exercises while building muscle strength and endurance around the knee to support improved function.
Resumption of activities (3–6 months)
Most patients are able to return to many normal daily activities and feel more comfortable and confident using their knee.
Maximum recovery (6–12 months)
Recovery continues gradually, with ongoing improvements in strength, movement, and overall knee function.
Address
St Edmunds Hospital,
St Mary's Square, Bury Saint Edmunds
IP33 2AA
Contact
Medical secretary: 07598271034