Knee replacement surgery treats severe knee pain that has stopped responding to other treatments, like pain medication. If you experience pain caused by conditions such as osteoarthritis or rheumatoid arthritis, knee replacement may help reduce your pain and restore your mobility. Total or partial knee replacement works by surgically removing part or all of a worn and painful joint and replacing it with a man-made joint (known as a prosthesis). Most people can return to normal life within 3 months of a knee replacement and you can return to many activities sooner.
There are different ways of performing a knee replacement and we can help you choose the right technique for your circumstances.
Total knee replacement is the most common type of knee replacement (more than 90% of knee replacements in Australia) and involves replacing all of the arthritic knee joint surfaces on the femur (thigh bone), tibia (shin bone) and patella (kneecap). The advantage of replacing all of these surfaces at once is it reduces the chance of you ever requiring further surgery on that knee.
We can talk to you further about the numerous techniques that have been developed in recent years to ensure you have a smoother recovery from your knee replacement. Knee replacements also last longer than previously due to improved techniques and materials.
Partial knee replacement can be the right option for patients with osteoarthritis that is limited to a small section of the knee (medial compartment primarily) with a particular interest in certain sporting activities. If you have a knee that is only worn in this part, with minimal angulation of your leg, an intact ACL, and meet several other criteria, this may be the best option for you.
There are numerous different ways of performing a knee replacement and your surgeon can help advise which is best for your circumstances.
A CT or MRI scan and a standing Xray of your leg alignment is used to map out your anatomy and prepare a 3D model of your knee. After calculating the loss of the cartilage that has occurred from your arthritis, we can restore your alignment to what it was before the arthritis developed (“kinematic alignment”).
Your surgeon can then determine the appropriate size of knee replacement for your knee, and where they need to make their cuts to restore your pre-arthritic lower limb alignment whilst preserving your ligaments and giving you a knee that is both mobile and stable.
To ensure this plan is accurately executed in the operating theatre, patient specific instrumentation is then 3D-printed to sit accurately on your unique knee anatomy intraoperatively and guide where the necessary cuts are to be made.
Robotic surgery involves the placement of several additional pins through separate incisions in the femur and tibia which are used as tracking devices to tell the computer where the knee is. This allows to guide the surgeon where to make the cuts. It is important to emphasise that the robot does not perform the cuts. It simply guides the surgeon where to cut based on the information that the surgeon has given the robot when registering your anatomy using the tracking devices. The current literature does not support this as being superior to other types of knee replacement.
Please note that techniques that work for one patient may not work for another and your surgeon will help guide you towards what technique is best for your anatomy and circumstances.
Anaesthesia for knee replacement surgery usually involves either a spinal anaesthetic or general anaesthetic, and many patients actually have some of each to optimise their pain relief and post-operative recovery. Consult with your orthopaedic surgeon and their anaesthetist to determine the most appropriate anaesthetic for you.
After your anaesthetic has worn off, you should be able to place full weight on your knee, with crutches or a frame to aid you. It is preferable that if your operation is done earlier in the day, you stand up on the same day as surgery to get used to being upright again. Sometimes you will even be able to go for a short walkNov 09, 2017
We will try to get you walking, sometimes with a frame, sometimes with only crutches as an aid.Nov 09, 2017
When you are comfortable and once you are able to walk independently and tackle stairs, that’s when you are safe to head home. Everybody is a little different and this timeframe is tailored to you as an individual.Nov 09, 2017
After 2-3 weeks, your wound will be checked (usually by a specialist wound nurse). Your surgeon will probably use dissolving suture and glue so no suture removal is likely to be required. After your wound review you should arrange to see your physiotherapist to begin post-operative exercises. We recommend against seeing your physio before the wound review to allow the wound to settle first.Nov 09, 2017
By two weeks you are probably down to using a single crutch in the opposite hand to your knee replacement. You will use this for longer walks and balance but can actually often get short distances around home without a gait aid. You will gradually disband this remaining crutch over the next few weeks depending on your stability.Nov 09, 2017
From 6 weeks post-surgery, you should be able to return to normal activities as. Some patients may be able to drive earlier, notably following a left knee replacement if you have an automatic car.Nov 09, 2017
Every surgery has some risks. Whilst the probability of these risks has been shown to be lower in the hands of experienced specialist knee surgeons they are nevertheless a possibility.
Your physician and surgeon will always put your health first, and will consult with you on any potential risks. Before surgery, your doctor will assess any risks involved with your current medications, medical history, and require your skin to be healthy.
Some risks present themselves only after surgery, such as infection and DVT. Ongoing medical check-ups with your physician will help identify and prevent any complications.
Most patients feel better than they were preoperatively by 6 weeks post surgery. You should be able to do many normal activities after 6 weeks though heavy manual labour and certain sports can take longer. Please note that time frames differ for each patient.
Physiotherapy is important to your recovery. Your first priority is to maximise your range of movement, both bending and straightening your leg. After a week or two, you can slowly begin increasing your walking distance and building your strength and stability. Note that although the swelling starts to settle after 1-2 weeks it can persist for over 12 months so the use of ice and/or a compression bandage can aid with this and thus improve range of motion.
If you have further questions or to find out about how a total knee replacement can benefit you, please get in touch today.
Advances in surgical techniques and prosthetics mean that you can expect knee replacement surgery to last for much longer than previously. Australian data shows that almost 90% of knee replacements last for 20 years or more. The majority of patients therefore only need their knee replacement done once. Whilst the need for revision knee replacement (re-do surgery to replace a worn-out replacement) is much more likely in younger patients, there is no specific age-limit on knee replacement surgery.
From being admitted to hospital to returning to the ward, the entire process of knee replacement surgery will take several hours. This includes preparation for surgery and recovering (waking up) afterwards. The surgery itself usually takes approximately one hour when performed by an experienced surgeon but is dependent on how complex your anatomy is.
While every individual is different, and recovery can be affected by many factors, you should expect to resume normal life by 6-12 weeks after surgery.
The majority of the cost of your knee replacement will be covered by your health insurance. Sunshine Coast Orthopaedic Group will advise you of any remaining likely out-of-pocket costs for after your consultation. These vary based on your fund and type of cover but will be itemised for you in detail after your pre-operative consultation.
Sunshine Coast Orthopaedic Group are very experienced at treating patients seeking to “self-fund” their knee replacement. Broadly speaking, rough total costs are generally around $25,000. One of the main costs in a knee replacement is the cost of the hospital stay and the total cost can therefore be lowered by shortening your hospital stay where it is safe to do so. Sunshine Coast Orthopaedic Group will never agree to lower the cost of your operation by using substandard implants or compromising on safety.
You are generally allowed to return to most activities of normal life after a knee replacement, even more strenuous ones such as skiing. Please be aware that higher impact use of your knee replacement may result in it wearing out sooner. Please also note that some patients report difficulty with kneeling down after knee replacement.
If you had your knee replacement many years ago, you may experience some wear in your knee replacement. This is because the materials used in those days often didn’t last as long as the materials now used. The time frame for this is generally years, but this may include a ‘loosening’ of the joint accompanied by pain or a sense of instability. If you have these symptoms, we recommend consulting your orthopaedic surgeon.
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Sunshine Coast University Private Hospital
Suite 12, 3 Doherty Street, Birtinya, QLD, 4575