Knee replacement is the surgical procedure which replaces the weight bearing surfaces of the knee joint to relieve pain and disability. The knee joint is replaced with metallic alloy components and a polyethylene, or plastic, liner. The operation is most often performed for osteoarthritis. It may also be performed for other diseases, such as rheumatoid arthritis, or maybe a salvage procedure after trauma to the knee.
Knee replacement surgery most often involves replacement of the whole knee joint. The lower end of the femur is replaced with a metallic component. The upper end of the tibia is replaced with a metallic component. The patella, or kneecap, may or may not be replaced with a polyethylene, or plastic, button. Cement may or may not be used to hold the implants in place. Mr Donohue will discuss these options with the patient prior to surgery.
Sometimes osteoarthritis only involves the medial or inner part of the knee joint. In this circumstance a partial, or unicompartmental knee replacement can be performed. This has distinct advantages in that a smaller incision is made and it is less invasive. No ligaments are removed. The recovery may be quicker. However, only a small percentage of patients are suitable for the partial replacement.
Mr Donohue will assess a patient with knee pain by taking a thorough history and performing an examination. Xrays will be looked at. Occasionally other imaging will be required.
The results of knee replacement are generally very good. 8 out of 10 patients make an excellent recovery from surgery. These patients have no pain or very minimal pain following the procedure. They are able to walk as far as they desire.
As with all operations, complications can occur. These are rare. The risks involved are things like infection, bleeding, blood clots, nerve or blood vessel injury, fracture, stiffness and failure of the implant. 90% of knee replacements last 10 years and many have lasted 20 years or more. Mr Donohue uses a modern type of implant which has a proven track record. He will always discuss the risks as well as the benefits of surgery prior to the operation being performed.
Medical complications can also occur after a knee replacement. This is a major operation. Often Mr Donohue involves a physician to supervise the medical management of the knee replacement patient. The physician will see you prior to the surgery and will be involved in your postoperative care in hospital.
Physiotherapy is very important after knee replacement. Patients can expect to be in hospital for 5 days. After that time patients may return home, or may go to inpatient rehabilitation. Physiotherapy aims to restore the motion, strength and function of the knee. Full recovery may take 3 to 6 months.
Mr Donohue normally reviews knee replacement patients at the 6 week mark. Regular reviews then occur until full recovery is achieved.
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