Total Knee Replacement
Dr Rodda and Dr Connon perform 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
A Total Knee Replacement (TKR), also known as Knee Resurfacing or Knee Arthroplasty, is an orthopaedic surgical procedure for conditions of the knee including arthritis. Over 1 million knee replacements are performed annually worldwide and it is a very common and safe procedure. It is called a total knee replacement because all of the cartilage surface of the knee is covered with a new surface, however less than 1cm of bone is removed from the femur and the tibia and the muscles of the knee and collateral ligaments are preserved.
Knee pain can be the result of inflammation, trauma, damaged cartilage or joint degeneration. The damage can lead to pain, joint weakness, instability and deformity, which can interfere with everyday tasks such as walking and driving.
The knee has three compartments. There is a medial compartment (on the inside of the knee) and a lateral compartment (on the outside of the knee) located between the femur (thigh bone) and tibia (shin bone). The third compartment is between the patella (knee cap) and the femur.
In a total knee replacement the medial and lateral components are replaced and the patella is often resurfaced. In a single compartmental replacement, as the name suggests, only one compartment is replaced. This procedure requires a shorter stay in hospital (between 2 -5 nights) with a quicker recovery time.
A straight incision of about 12cm is made over the front of the knee. The main knee tendon is then moved to the side and the surfaces of the knee joint exposed. The edges of the damaged cartilage are cleared and the surface prepared for implants.
Components are fixed to the bone using either bone cement or coated synthetic products which encourage the bone to grow onto their surface. Depending on your situation, one or other method will be more suitable. Advanced computer technology is utilised to ensure that the implants are positioned correctly.
Prior to surgery a number of routine blood tests, X rays and tests may be conducted to ensure you are a suitable candidate for surgery. Dr Rodda or Dr Connon will also want to check your current medication or find out if you have an artificial heart valve or other implant which may affect your surgery. These routine tests and questions are necessary for your wellbeing and safety.
Depending on your procedure, most patients are able to go directly home after several days in hospital and patient rehabilitation may be required. A physiotherapist will be able to assist you get your movement back once you are at home. Pain levels can vary from one person to another but it’s important to keep working at exercise and bending the knee once you are discharged.
The main benefits of a successful Total Knee Replacement are:
- A reduction in or total elimination of pain – usually rapid and significant
- An improvement in mobility – your knee will move smoothly again and function more normally
- A better quality of life. Everyday activities such as walking and bending will no longer be restricted or limited by pain.
Most knee replacement surgeries are very successful and patients are delighted with the improvement in their quality of life, however there can be some risks including:
- Wear and tear on bearing surfaces which produces small particles of debris. These can loosen the knee replacement components which can cause a recurrence of pain. If you require a second operation this is usually a more complicated procedure which does not produce as good results
- Risk of infection, which can occur after any operation. Precautions include the administration of intravenous antibiotics and the use of advanced computer technology to ensure the accuracy in the alignment of the implants
- Blood clots, which are more common after this type of surgery. Blood thinning drugs are used to prevent such a problem and additional measures may be taken if you are thought to be at greater risk
- Bleeding and blood vessel or nerve injury
- Failure of the procedure to relieve pain
- Stiffness instability
If you are concerned about any of these risks, please talk to Dr Rodda or Dr Connon who will be able to provide you with more information.
Why should I consider a Total Knee Replacement?
If you are experiencing pain, stiffness, a reduction in the quality of your life or the symptoms of arthritis, a TKR may be the solution. It provides a safe, rapid and significant reduction in knee pain and improves the quality of life through restoring mobility.
Who is suitable for surgery?
If you have moderate or severe arthritis and cannot manage your symptoms through other means, you are generally suitable for a TKR. If weight loss, painkillers, anti-inflammatories, physiotherapy and other therapies are not helping or relieving your discomfort, then you may be a candidate for surgery. To assess your suitability, Dr Rodda or Dr Connon will take a careful clinical history, examine your knee and take X-rays. Only then will they determine whether or not you should have the procedure.
Will I have much pain?
All procedures involve a certain amount of discomfort however with major advances in the development of anaesthetics along with the high level of surgical care provided by Dr Rodda or Dr Connon and their team, you can feel reassured that your pain will be kept to a minimum during recovery and you will be made to feel as comfortable as possible.
What happens after surgery?
Most patients feel a little disorientated when they first wake up from anaesthetic. You may feel thirsty or hungry but you are usually able to eat and drink almost immediately. As soon as your nerve block wears off, we like to have you up on your feet and bending your knee. We provide an ice pack to help reduce the swelling and may insert a thin catheter to administer additional local anaesthetic into your knee to help reduce any discomfort. A physiotherapist will help you with your rehabilitation and typically within 3-4 days you’ll be on your way home!
What happens once I’m home?
We will organise for a physiotherapist to visit you at home a day or two after you leave hospital. Over the first 2 weeks your activities will usually be limited but you will be able to walk short distances. You will then have a follow up appointment with Dr Rodda or Dr Connon in around 2 weeks when he will check your progress and answer any questions that you may have. Dr Rodda and Dr Connon provide a high level of post-surgical care and places a high level of importance on patient treatment and follow-up. Patients typically return to driving about 6 weeks after the operation.