If your knee is damaged in all three areas (medical, lateral and patellofemoral) you may be a candidate for bicompartmental or total knee replacement.
Your knee is composed of three compartments:
- Medial - the inside part of your knee
- Lateral - the outside part of your knee
- Patellofemoral - the front of your knee between your kneecap and thighbone
Over time, the surfaces on the knee joint can start to wear. This can be caused by arthritis or a previous injury to the knee. Arthritis is painful as joints become stiff and inflamed when the smooth lining between the joints gets damaged or wears away. Without the protection of this lining, the rough surfaces of your bones rub together as you move causing the pain that is all too common to sufferers.
What happens during knee replacement surgery?
A knee replacement is normally performed under general anaesthetic. During the operation your whole existing knee joint is replaced with a new prosthetic knee joint. This takes between one and two hours. Your surgeon will make an incision (cut) at the front of your knee where the replacement will be inserted. Usually, you will stay in hospital for 2-4 days, but you may have to stay longer if necessary.
After the operation
Once your operation is over, you’ll be taken to the recovery room where you will wake from the anaesthetic. Your wound, blood pressure and pulse will be checked carefully. You will have a large dressing covering your wound. You may have a small tube coming out of your wound - this is to drain away any excess fluid from the inside of the wound. You may also have a drip (infusion) going into your arm. This will keep you hydrated until you are able to drink, and can also be used to give you pain relief. When you are stable and comfortable, a nurse will take you back to your room.
Getting up for the first time
We understand that you may be anxious or worried about getting up, but we will do all we can to help and reassure you. Don’t worry, a member of our Healthcare Team will be there to help you, whenever you are ready. The reason for getting you moving is to improve your circulation and avoid stiffness.
You may be feeling tender and sore, but you can get pain relief medication to deal with any discomfort – just ask one of the nurses if you have any pain. Once out of bed, you will continue to wear support stockings to help your circulation. The physiotherapists will work with you during your stay to help give you the best start with your new joint.
Going home after knee placement
Before discharge you will have an X-ray of your new knee to check its position. We will do all we can to help and reassure you.
A physiotherapist will give you some exercises to help get your new knee moving. These are important to help you make a good recovery. The therapist will also show you how to walk up and down stairs and make sure you are confident at doing this before you go home. You won’t be able to drive, so you will need someone to come and take you home from the hospital.
When you go home, you may need some help with shopping and household chores. It’s a good idea to arrange for someone to stay with you - or at least look in on you daily for at least a week.
It’s usual to return to see your consultant as an outpatient after your operation. You may also need to have stitches removed. You’ll be given information about these appointments before you go home. We’ll also give you some pain relief medication to take with you.
When you get home you will be tired for several weeks and should rest. However, it’s also important to aim to gradually increase your physical activity each day, so you should continue with the exercises the physiotherapist showed you. These will help to reduce stiffness and strengthen your legs. You will need to keep using crutches or a walking stick for a while. To help you manage and increase mobility it’s recommended that you take any pain relief medication we have prescribed. Continue taking this until you are pain free.
So you don’t damage your new knee and to help your wound heal, you should:
- Use the shower instead of the bath
- Keep wearing your support stockings - you may have to do so for four to six weeks
Getting back to normal
Everyone heals differently. You will continue to improve over the next six to twelve months. Your scar should fade to a thin white line.
Depending on what type of job you do, you should be able to return to work within twelve weeks. You may want to think about a phased return to work.
After your follow visit with your surgeon you should released to drive but only if you can comfortably operate the pedals and control your car in all situations. This includes an emergency stop. If you are in any doubt about your insurance cover, it’s best to contact your insurance company.
Most people make a good recovery and return to normal activities following knee replacement. As with any surgery there can be complications:
- Infection of the surgical site (incision)
- Blood clots (DVT - deep vein thrombosis)
- Difficulty passing urine
- Chest infection
- Heart attack
Risks specific to knee replacement surgery are:
- Numbness on the outside of the knee caused by a nerve being cut during surgery
- Stiffness - there may need to be further, minor surgery to improve this
- Pain when kneeling
- Bleeding around the joint - this usually settles but may need to be drained by a surgeon
- Fluid build-up around the joint
- Rejection of the prosthesis
- Infection in the joint
- Deep vein thrombosis (blood clot).
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