Knee Replacement Surgery Questions

I have been told I need a knee replacement. What are the alternatives:

It is only the patient who can decide whether to have joint replacement surgery to the knee as it is based on pain levels and restrictions in daily activities. There are alternatives to knee replacement surgery including weight loss, simple analgesics and modification of lifestyle. Some patients who fail conservative management may elect to have the knee injected which may provide pain relief for short periods. Arthroscopic surgery to the knee is sometimes beneficial if there are associated cartilage (meniscal) tears or loose bodies within the joint causing mechanical type symptom.

Can I kneel after a knee replacement?

20% of patients find it uncomfortable to kneel after a knee replacement and prefer not to. Some surgeons prefer you not to kneel on the knee replacement they have performed. Mr White is happy for you to kneel as long as it is comfortable for you, although it is likely that you won’t be able to kneel for the first three to four months after surgery.

I have heard it takes a long time to get over knee replacement surgery. Is this true?

In general patients recover well following knee replacement surgery and the first part of the recovery is very rapid. Knee function can continue to improve up to 12-18 months after the initial surgery. However, for most patients they are able to stand and walk the next day with aid and should be able to drive six weeks after surgery as long as all of the post-operative checks have been satisfactory. Some patients experience post-operative swelling, night time pain and heat from the knee for the first three to six months after surgery. This can be entirely normal although does require review by your treating surgeon.

What are the complications of hip and knee replacement surgery?

Most patients (95%) undergo surgery without any complications whatsoever and return to a good level of function post-hip and knee replacement surgery. It has to be remembered that hip and knee replacement surgery is still major surgery and is associated with complications as outlined below. Even if you get one of these complications, it should be possible to work through these problems to obtain a satisfactory result with the help of your surgeon and physiotherapist.

  • Post-operative complications
  • Medical:
    • Heart and chest problems
    • Deep vein thrombosis
    • Pulmonary embolism
  • Complications of anaesthesia
  • Surgical complications – Hip:
    • Infection
    • Dislocation
    • Wear
    • Loosening
    • Leg length discrepancy
    • Bone and nerve injury
  • Surgical complications – Knee:
    • Infection
    • Persistent pain
    • Stiffness
    • Bone and nerve injury
    • Instability

As noted above, some of these can be overcome with further treatment or surgery. Your surgeon can advise if you are aware of any increased risk of the above complications.

I have had my hip or knee replaced but I am still having problems.

Sadly, as noted above, some patients do have initial problems following their hip or knee replacement and some problems develop some years after implantation of hip and knee replacements. A painful joint replacement needs rigorous and thorough investigation by an expert dealing with these issues on a day to day basis. Further surgery is usually complex although excellent results are now being achieved.