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Knee Replacements

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WHAT IS A TOTAL KNEE REPLACEMENT PROCEDURE?
A Total Knee Replacement (also known as a Knee Arthroplasty) replaces all parts of the natural surface of the knee joint with an artificial devise known as knee prosthesis. A knee prosthesis is typically made of metal and plastic components. The metal components cover the surfaces of the damaged or diseased knee joint surface and the plastic component acts as a buffer or shock absorber between the two. In some patients the knee cap (Patellar) may also require a corrective resurfacing procedure and fixing with a new prosthetic lining.

WHY IS A TOTAL KNEE REPLACEMENT PROCEDURE PERFORMED?
A Total Knee Replacement is usually performed on individuals over the age of 55 who have experienced chronic and debilitating knee pain that will not respond to non - surgical treatments. Joint 'wear and tear' between the surfaces of the thighbone (Femur) and shinbone (Tibia) caused by degenerative conditions such as Osteoarthritis or Rheumatoid Arthritis are the two most common reasons for performing a Knee Replacement. Total Knee Replacement may also be recommended to patients who suffer with a condition caused by a decreased blood supply and subsequent decay of the joint known as Avascular Necrosis.

HOW IS A TOTAL KNEE REPLACEMENT OPERATION CARRIED OUT?
A Total Knee Replacement can be performed under General Anaesthetic (you will be asleep) or Spinal/Epidural Anaesthetic (you will be awake, but sedated). The procedure usually takes around one and a half hours to complete and is performed with a patient positioned on their back on the operating table throughout the procedure. A longitudinal incision is made on the front of the knee in order for the surgeon to move the kneecap out the way and then use various instruments to resurface the joint in preparation to attach the knee prosthesis.

There are two types of knee prosthesis a) a cemented version and b) an un-cemented version. Your Consultant Surgeon will advise which would be the best type for your individual condition and age range. Following the insertion of the new knee prosthesis the wound is usually closed with absorbable stitches and a surgical drain inserted to minimise the risk of any developing blood clots.

WHAT IS THE RECOVERY AFTER SURGERY LIKE?
Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as active and mobile as possible to avoid serious complications such as Deep Vein Thrombosis (DVT) from developing. It is therefore normal for patients to be encouraged to take a few steps with the support of a walking frame and guidance from a physiotherapist the day after surgery. Following a progressive improvement of mobility and pain control patients are normally discharged home around four to five days following their surgery. By the time the required level of recovery is achieved for discharge, patients are normally free of drains, wearing a simple wound dressing, eating and drinking normally, walking with just the aid of a stick and taking only mild analgesia (pain killers).

Over the next six weeks patients will be expected to work on improving their own mobility and range of hip movement through dedicated and progressive physiotherapy and by increasing their daily activity and walking distances. Your Consultant Surgeon will then assess your knee joint range of movement after six weeks and then again after three months to evaluate how successful your knee replacement operation has been. Patients who are in employment should not resume work until after their first consultation and dependant on the physical nature of their job may be advised to take longer off work. Patients should expect a continuous and full physical recovery to take up to six months to achieve

ARE THERE ANY RISKS ASSOCIATED WITH TOTAL KNEE REPLACEMENT SURGERY?
Although Total Knee Replacement surgery is very commonly performed without any complications occurring, it is very important that all candidates are fully aware of both the benefits and risks of undertaking such major surgery. All surgery, no matter how expertly or carefully it is performed carries risks and the importance of a full evaluation and consultation to discuss your condition in relation to these risks cannot be over emphasised.

HOW DO I FIND OUT IF I AM A SUITABLE CANDIDATE FOR A TOTAL KNEE REPLACEMENT PROCEDURE?
At NW Specialist Clinic our Consultant Surgeons will carry out a full evaluation of your individual symptoms and circumstances and provide you with a comprehensive verbal and written explanation of your condition and recommend the most appropriate solution to improve your condition. Our expert Consultant Surgeons understand the importance of the decision you are making when contemplating Total Knee Replacement surgery. Throughout your consultation you will be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any recommended treatment.