Total knee replacement

📖 Introduction

A Total Knee Replacement (TKR) — also called Total Knee Arthroplasty — is a highly successful operation that replaces the damaged surfaces of your knee with metal and plastic implants (prostheses).

It’s usually recommended for people with severe knee arthritis that limits everyday activities and doesn’t improve with non-surgical treatments.

🦵 What is Arthritis and Why TKR?

Arthritis can wear away the smooth cartilage that allows your knee to move easily. When the cartilage is damaged or lost, bones rub against one another, causing pain, swelling, stiffness, and deformity.

Common causes of knee arthritis:

Primary (wear and tear) osteoarthritis
Trauma or fractures
Being overweight
Infection
Bleeding disorders
Connective tissue disorders
Inflammatory conditions (e.g. Rheumatoid arthritis)

In an arthritic knee:

Cartilage is worn thin or missing
The joint capsule and linings swell
The joint space narrows and may look uneven on X-ray
Bony spurs (osteophytes) can form around the joint

This damage often leads to stiffness, pain, and reduced mobility.

✅ Benefits of Total Knee Replacement

A TKR can provide:

Relief from severe knee pain
Improved walking and daily function
Easier mobility and less stiffness
Correction of deformity (bow legs or knock knees)

Before deciding on surgery, you will have tried conservative treatments such as:

Pain medication and anti-inflammatories
Weight loss and activity modification
Physiotherapy and muscle strengthening exercises
Walking aids (e.g. sticks)

If these treatments no longer control your pain, a knee replacement may be recommended.

🏥 Before Surgery

Your pre-operative checks will include:

Blood tests and pre-assessment
Managing any other health issues
Stopping smoking and some medications (e.g. herbal supplements) 10 days before surgery
Arranging support at home for your recovery

🏥 On the Day of Surgery

You’ll be:

Admitted to hospital and checked in by nursing and anaesthetic teams
Given a spinal or general anaesthetic
Taken to the operating theatre and prepped for surgery

🔧 The Surgical Procedure

Your knee will be:

Opened through a small incision (approx. 10-15 cm)
Resurfaced with precisely shaped metal components on the femur and tibia
Fitted with a smooth plastic liner in between
The kneecap may also be resurfaced if needed
Fixed into place with surgical cement

The procedure usually takes less than an hour and is carried out under sterile conditions.

🏡 Post-Operation Recovery

You’ll wake up in recovery with:

IV drips and pain control (oral medication or PCA machine)
Ice and compression on your knee
Physiotherapy starting as soon as you’re comfortable — often the same day
Usually go home 2-3 days after surgery

Your physiotherapy goals will include:

Practising gentle exercises to straighten and bend your knee
Getting up and walking with support
Gradual improvement to regain strength and mobility

📈 Milestones

1–2 days: Start walking with a frame
6–8 weeks: Off crutches, comfortable with light daily activities
By 3 months: Returning to most normal activities
Long term: Improved pain, mobility, and quality of life

⚠️ Risks and Complications

As with any surgery, there are risks to be aware of — these are rare, and Mr Frame will do everything possible to prevent them:

Medical risks:

Blood clots (DVT/PE)
Heart attack, stroke, kidney or lung complications
Infections of the chest or bladder
Anaesthetic reactions

Knee-specific risks:

Infection: ~1 in 200 (may require antibiotics or further surgery)
Deep vein thrombosis (DVT): Prevented with injections, stockings and early mobilization
Stiffness: Physiotherapy is key to regaining movement
Nerve or blood vessel damage: Very rare
Persistent pain or swelling: Occasionally ongoing
Loosening or wear of the new joint over time: May require further surgery
Fractures: Rare and treatable
Patella problems or ligament injuries: Very rare
Numbness around the scar: Common and usually improves

🏡 Going Home & Long-Term Care

✅ After discharge:

Rest, elevate your leg and use ice regularly
Take pain relief as prescribed
Complete your physiotherapy exercises
Avoid stairs and trip hazards at home until you feel stable
You’ll see Mr Frame for a follow-up at 6–8 weeks

✅ You can shower once the wound is healed — waterproof dressings help until then.

✅ Driving is usually possible after 6 weeks — once you can do an emergency stop safely.

✅ Long-term outlook:

90-95% of knee replacements last 15+ years
80% report significant pain relief and improved function
10% may have some ongoing discomfort, often mild

💬 Summary

Total knee replacement is one of the most successful operations available for knee arthritis. For most patients:

It significantly improves pain and mobility
Provides long-term relief
Enables you to live a more active, independent life

We want you to feel informed and supported every step of the way. If you have any questions or concerns, please contact Mr Frame or the team at info@wessex-knee.com.