Total Knee Replacement (TKR) is a procedure undertaken for knee arthritis when the symptoms of arthritis are sufficiently disabling and the arthritis is beyond a point where simpler measures are effective.
The procedure is most commonly used for osteoarthritis. This is the common ‘wear and tear’ form of arthritis in which the normal cushioning layer of cartilage which coats the joint surfaces has worn away, causing pain, stiffness, swelling, instability and deformity.
Total Knee Replacement is a major procedure in which the worn out and damaged joint surfaces are replaced with artificial bearing surfaces.
The usual advice to patients considering a Total Knee Replacement is ‘don’t rush in’. It is always useful and safer to try non-operative measures first. These include:
- Simple pain relief like paracetamol e.g.: Panadol Osteo.
- Anti-inflammatory agents. Talk to your GP to ensure they are safe for you to take.
- ‘Natural Remedies’ like fish oils, turmeric etc. probably work by an anti-inflammatory action too. Always keep your GP in the loop as some of these substances might interfere with prescription medications.
- Physiotherapy, osteopathy.
- Weight loss.
- Exercise if possible.
Even if a knee replacement seems inevitable, your recovery will benefit from the conditioning and health benefits from the last two measures.
A ‘tincture of time’ will also ensure that your pain from arthritis is here to stay and not a temporary flare.
During your consultation the advantages and risks of the procedure will be discussed.
The Operation and Recovery
The operation involves removing, in a very precise way, a small amount of bone and any residual cartilage from the end surface of the femur (thigh bone) and tibia (shin), correcting for any deformity and then securing into place the components. The components are made of high strength and durable metal and polyethylene (a type of plastic).
The incision is placed at the front of the knee and you will need to begin bending the knee (and the incision) from Day One. It will be uncomfortable and challenging. However, we use innovative techniques using targeted local anaesthetic that will help manage the discomfort in the first 48 hours.
Most of the time you will be up and about on the day of surgery or the next day. Expect to be allowed home by the 5th day post op with a referral to a physiotherapist and a programme of exercises to do at home. The option exists for inpatient rehabilitation.
Expect to require strong oral painkillers or a pain patch for some weeks so that you can do your exercises. Patients recover at different rates and experience pain differently but on average expect a gradual recovery over 3 months, although further improvements in strength and function will occur over 12 months.