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KNEE REPLACEMENT SURGERY
The surgeons at Sunshine Coast Orthopaedic Group performs a variety of surgical procedures including: Total Knee Replacement, Knee Arthroscopy, Ligament Reconstruction and Revision surgery, and Trauma surgery including femoral and tibial fractures.
TOTAL KNEE REPLACEMENT
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.
TYPES OF KNEE REPLACEMENTS
There are different ways of performing a knee replacement and we can help you choose the right technique for your circumstances.
TOTAL KNEE REPLACEMENT
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.
PARITAL KNEE REPLACEMENT
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.
SURGERY TECHNIQUES
There are numerous different ways of performing a knee replacement and your surgeon can help advise which is best for your circumstances.
PATIENT SPECIFIC INSTRUMENTATION
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.
ROBOTICS
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.
BENEFITS
REDUCTION IN KNEE PAIN
With arthritis and other conditions, the cushioning layer of cartilage within the knee joint is worn down, causing pain. Surgery removes and replaces the damaged joint with a prosthesis which can reduce pain on movement and at night. This reduction in pain can often last for the rest of the patient’s life without further surgery.
INCREASE MOBILITY
A damaged joint can limit your walking distance. Knee replacement surgery can get you walking further with less pain.
QUALITY OF LIFE
With a reduction in pain and an increase in mobility, knee replacement patients are usually able to return to a relatively normal life, taking part in many pre-pain activities.
KNEE REPLACEMENT PROCESS
SURGICAL ANAESTHESIA
SURGERY
POST SURGERY
SURGICAL ANAESTHESIA
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.
SURGERY
To begin, your surgeon will make an incision over the knee. The surgeon then removes the damaged bone and cartilage from the knee joint.
The damaged arthritic surfaces are replaced with metal components covering the femur and tibia. A hard-wearing polyethylene (plastic) spacer is placed in between these two metal components to allow them to glide smoothly on each other. These are manufactured in 1mm increments, allowing selection of the right size to be implanted in your knee to maximise stability and range of motion. These are generally held in place with bone cement (polymethylmethacrylate). Finally, the arthritic surface of the patella (knee cap) is replaced with a polyethylene component.
POST SURGERY
The time spent in hospital following knee replacement surgery varies according to your needs and personal circumstances as a patient. To go home we need to ensure your pain is well controlled and you are able to safely get around your own home with the use of crutches or another gait aid to assist you as required. The majority of patients spend about 3-4 days in hospital, but some people are keen and suitable to go home earlier and some patients can stay for longer- it is dependent on your specific circumstances.
It is becoming relatively uncommon for patients to need inpatient rehabilitation after a total knee replacement because various advances in recent years have ensured most patients are able to recover faster with less pain from their surgery and are hence able to safely return directly to their own home. Community services have also significantly improved so many patients choose the comfort of their own home. Some patients still require inpatient rehabilitation and this is usually determined based on how the individual progresses with physiotherapy after surgery- we can’t always predict it beforehand. We will do our best to tailor your post-operative rehabilitation program to your needs and preferences.
RECOVERY TIMELINE
DAY OF SURGERY
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 walk
Nov 09, 20171 DAY AFTER SURGERY
We will try to get you walking, sometimes with a frame, sometimes with only crutches as an aid.
Nov 09, 20172-5 DAYS
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, 20172-3 WEEKS
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, 2017BETWEEN 2 TO 6 WEEKS
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, 2017AFTER 6 WEEKS
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, 2017SURGICAL RISKS
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.
RECOVERY AND EXERCISES
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.
FAQS
How long does a knee replacement last?
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.
How long does a knee replacement take?
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.
How long does it take to recover from knee replacement?
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.
Are knee replacements covered by my health insurance?
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.
What if I don’t have health insurance?
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.
Can you overdo exercise after knee replacement?
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.
How do I know if my knee replacement is failing?
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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CONTACT US
If you would like to book an appointment with any of our practitioners, please contact us. We can be reached on the details below, or alternatively, leave your details in our form and we’ll get back to you.
If you’re unsure of what service you need, please give our friendly team a call and they can lead you in the right direction
- Phone: 07 5493 8038
- Fax: 07 5301 8154
- Email: click here to email
Sunshine Coast University Private Hospital
Suite 12, 3 Doherty Street, Birtinya, QLD, 4575
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