• Mr Simon Garrett

A Pocket Guide To Total Knee Replacements


Total knee replacement surgery (TKR) is usually performed on patients who have a worn-out or arthritic knee joint where symptoms have failed to respond to non-operative treatments such as painkillers and physiotherapy. Knee replacement surgery is an excellent pain-relieving operation that enables patients to return to doing what they love, pain-free.


In this pocket guide to total knee replacements, I will guide you through some essential information and popular FAQs.


Contents
  1. Alternatives to TKR

  2. What does a TKR involve?

  3. What are the risks of TKR Surgery?

  4. How much does a TKR cost?

  5. What happens after the operation?

  6. How long will you be in the hospital?

  7. How long will you need off work?

  8. How long until the knee is pain-free?


1. Are there alternatives to a total knee replacement?

Alongside painkillers, dietary supplements such as Glucosamine & Chondroitin and cod liver oil can help alleviate some of your symptoms. Steroid (cortisone) injections can also be very successful initially, however, they tend to become less effective with repeated injections and they cannot be performed too often.

Keyhole (arthroscopic) knee surgery as operative treatment is generally not successful for very arthritic knees and is not recommended in the NICE guidelines.

2. What does the operation involve?

We will use a variety of anaesthetic methods, most commonly it will involve a 'spinal' (local anaesthetic injection in the back) which means that you can be as awake throughout the procedure as you wish. This avoids the risks of a general anaesthetic and gives good pain relief in the initial post-op period should patients prefer. This will be discussed and decided during your pre-op consultations.


During the operation, an incision is made on the front of the knee using specific equipment, and the damaged joint surfaces are removed. The ends of the bones that form the knee (tibia and femur) are resurfaced with specially designed prostheses made of cobalt-chrome and titanium. In addition, a polythene (very hard-wearing plastic) bearing fits on the tibial component and articulates with the femoral component. The components are held in place with bone cement and the kneecap is only replaced if it is very badly affected.

The operation itself usually takes an hour which most patients are fairly surprised about.

3. What are the risks?

All surgery carries an element of risk, however, knee replacement surgery is a very successful pain-relieving and function-restoring operation. The main risks are infection (1%), stiffness (1%) and blood clots (2%).

The knee replacement may loosen after a number of years and become painful. This may mean revision surgery is required. I use knee replacements that have excellent long-term results with a proven track record. The quality of the replacement does truly make a difference.



4. How much does a total knee replacement cost?

For knee replacement surgery the cost will be between £11,000 - £13,000 depending on the location, and the procedure. This price is inclusive of follow-up consultations, the surgery itself and physio/aftercare. Initial consultation to investigate the exact cause of your knee pain with me at my private clinics in Poole, Bournemouth and Dorchester is £250.



5. What happens after the operation?

Following your operation, you will be able to put your full weight through the leg straight away and the physiotherapists will aim to mobilise you on the day of surgery. The quicker you are able to 'get up and about' the lower your risk of developing blood clots.


Your assigned physios will show you how to use crutches or a frame if need be and they will ensure that you can mobilise adequately such as getting up and down stairs before you are discharged. Therapy will also continue for several sessions as an outpatient.



6. How long will you be in the hospital?

Patients are pleasantly surprised to hear that they will usually be able to leave the hospital after 2 - 4 days!


7. How long will you need off work?

This is variable and depends really on the nature of your work and what you do on a typical working day. As a general rule, you will be uninsured to drive for six weeks following the operation. Most people would probably require a similar time off of work, however, working from home would be possible after a couple of weeks.


8. How long until the knee is pain-free?

Generally, most of the pain subsides within 6 weeks and most patients can mobilise without the need of any crutches or sticks. By 3 months, almost all patients are pain-free and very happy with the results. It can take up to 18 months for the knee to fully settle though. It is good to be aware that patients will probably always find kneeling uncomfortable thereafter.


 

I hope that this pocket guide has helped you understand what total knee replacement surgery involves. If you have any further questions or would like to make an appointment to see me about your knee pain at one of my private clinics here in Dorset, do not hesitate to contact my friendly team who will be able to assist you. We will get you back on your feet as quickly, and comfortably, as possible.