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Knee replacement

The Prosthesis
There are several types of knee replacement:

Total replacement:   The femur is resurfaced by a metal shell and this articulates with a plastic tray that is fixed to the tibia. The undersurface of the knee cap is often lined with a plastic button.

Unicompartmental replacement:  Only half of the knee is replaced. This type of replacement is suitable for cases where the arthritis is well localized.

Patello-femoral replacement:  Relatively rarely used this replacement resurfaces just the bearing between the patella (kneecap) and the femur.

The Surgery

Knee replacement is done under either a general or regional anaesthetic. An incision about 10 to 15 cm long is made over the front of the knee; the exact size and position of the incision depends on the type of replacement being implanted. The operation typically takes about 1 to 1½ hours.

When you return to the ward you will have a 'drip' in your arm and may also have a drain coming out of your wound. Blood transfusion is required in only about 10% cases. You will be given painkillers to relieve any discomfort.

You will start walking within 12 to 24 hours of surgery. Initially you will require a frame but within a day or so you will be using crutches or sticks. You will be taught to climb stairs after 2 to 3 days. You will then be fit for discharge which usually occurs on the fourth or fifth postoperative day.

Outpatient physiotherapy will be arranged. You will be seen in clinic 6 weeks following surgery but should contact the hospital if you have any concerns before then.