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Knee Replacement Operation

Overview

Knee replacement operation is sometimes the only surgical option available to patients with advanced arthritis of the knee.


The knee replacement operation is a surgical procedure aimed at replacing the worn out parts of the arthritic knee with specially designed metal and plastic components. The aim of the procedure is to relieve the knee pain and improve the patient’s mobility. It is mainly used in patients with osteoarthritis but it can be used in patients with inflammatory arthropathies, such as psoriatic arthritis and rheumatoid arthritis. It can be carried out as a total knee replacement or as a partial knee replacement. The knee is arbitrarily divided into 3 compartments: the medial (inner), the lateral (outer) and the patello-femoral. Any of these compartments can be replaced if they are diseased, without replacing the entire knee joint. Patient selection is crucial. Patients may therefore have an investigative key-hole procedure before undergoing their knee replacement, in order to ensure they are suitable for the planned procedure. Sometimes the decision is made at the time of the knee replacement. In either case, the best option suited to the individual is selected.



X-ray after Total Knee Replacement Operation

X-ray - Total knee replacement operation

Total knee replacement operation

This operation involves replacing all parts of your worn-out knee with metal and plastic components. The aim of the operation is to relieve the pain of advanced arthritis and try to improve your mobility. This operation is performed when measures such as physical therapy, life-style modification, injections and pain-killers have failed to adequately control your symptoms. Depending on your age at the time of operation, you may require a revision of your knee replacement in the future. Implant longevity is improving all the time and is your implant is very likely to last you well over ten years.

Like every other operation, a total knee replacement carries with it risks (such as infection, blood clots, bleeding, ets...) as well as benefits. These are covered in more detail in the "Your questions answered" section. Meticulous care is taken before, during and after the operation to minimise the risk of complications. However, a total knee replacement is a major undertaking. The rehab period is prolonged and the recovery takes months. But in the right candidate it can be a life changing event.



X-ray after Partial Knee Replacement Operation

Partial knee replacement operation - The medial/inner compartment has been replaced.

Partial knee replacement operation

This variant of knee replacement operation is performed in patients who have only worn out 1 of the knee’s 3 compartments, with the other compartments remaining healthy. There are also a number of other criteria that a patient has to fulfil before a unicompartmental knee replacement is recommended. Most patients tend to wear out the medial (inner) compartment first and therefore the procedure to replace this part of the knee is carried out much more commonly. Lateral (outer) compartment can also be replaced. As the operation involves replacing just a part of the knee, the scar tends to be smaller, there is less pain post-operatively, the range of movement of the knee is greater and the recovery is quicker.

 

Watch: Total Knee Replacement Implant

knee replacement implant
 
X-ray after Patello Femoral Replacement Operation

Patellofemoral Replacement operation

Patello-femoral replacement operation

This operation is best suited for patients who have wear and tear between the patella and the V shaped groove it sits in called the trochlea (which is at the end of the femur/thigh bone), but in whom the rest of the knee is relatively healthy. The worn out portion of the patella is removed and replaced with a plastic patella "button". The worn-out groove it sits in, the trochlea, is removed and replaced with a metal component. Overall aim of the operation is to relieve your knee pain and to give you a functional range of knee movement. Like with all other types of knee replacement operation, there are risks involved and these are discussed in the "Your questions" section.




X-ray after Revision Knee Replacement Operation

Revision knee replacement operation

Revision Knee Replacement operation

Knee replacement designs are improving all the time. However, even with these advances, there may be occasions when a knee replacement does not last you a lifetime. If complications occur, such as infection, fracture or loosening of the implant, the knee replacement may need to be re-done. Surgically, this is a bigger undertaking than the first knee replacement operation. If a knee replacement is being revised because of infection the revision operation may need to be carried out in stages to ensure infection has been eradicated. Most modern knee implants are expected to last for at least 10 years and in mot cases upwards of 15 years.

 


 

Example of Patient - 12 weeks post a left and 14 weeks post right medial partial knee replacements

61 year old patient , 12 weeks post a left and 14 weeks post right medial partial knee replacements. This patient suffered severe incapacitating knee pain.

Mr Wilson first operated on his left knee. In just 2 weeks after the operation, the patient could feel no pain in the knee. He then had the same operation carried out on his right knee and was off crutches within a week of the operation.

mrward

partial knee replacement post op

Post Operation x-ray

partial knee replacement pre op

Pre Operation x-ray





Example of Patient - 2 weeks following a partial knee replacement

This is an 82 year old gentlemen two weeks down the line following his left partial knee replacement and 3 months following his right partial knee replacement.

 

He no longer required any pain killers or walking aid - he was pain free at this stage. Not all patients recover this well after two weeks following a partial knee replacement, but many do.

 

The partial knee replacement is done through a minimally invasive technique, the surgery takes
less than an hour to perform. Most patients only require one or two nights in hospital. Most of this patient's knee has been left untouched, therefore the recovery is much quicker.

 

 

 

Partial Knee replacement - before surgery

Before surgery

 

 

 

 

 

 

 

 

 

 

 

 

 

Partial Knee replacement - after surgery

After surgery

 

 

 

 

 

 

 

 

 

 

 

 

 

 

"Prior to the operation I had a degree of trepidation about the outcome, pain and recovery period; how long would I be out of action? To date I am delighted with progress and the state of the scar; very neat considering and has healed extremely well. "

 

 

scar after surgery

Scars after the surgery - left knee (2 weeks), right knee (8 weeks)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Example of patient - 6 weeks following A Total Knee Replacement

Post op images
Post Total Knee Replacement Operation - Near Full Extension

Full Extension

Post Total Knee Replacement Operation - Near Full Flexion

Full Extension

Post Total Knee Replacement Operation - Near Full Flexion

Good Flexion



6 weeks post total knee replacement


 

 

Example of patient 4 weeks following A Partial Knee Replacement

Pre operative xrays - no space on medial side of knee with well preserved lateral compartment
Pre Operative X-ray of Partial Knee Replacement

Post op x-rays
Partial Knee Replacement Operation - Frontpage View X-ray

Front View X-ray

Partial Knee Replacement Operation - Sideview View X-ray

Side View X-ray



Post op images
Post Partial Knee Replacement Operation - Near Full Extension

Near Full Stretch

Post Partial Knee Replacement Operation - Near Full Flexion

Near Full Flexion

Post Partial Knee Replacement Operation - Near Full Flexion

Near Full Flexion

partial knee replacement surgical wound

Surgical Wound



Watch: Total Knee Replacement Implant 4 weeks post partial knee replacement


 

Orthopaedic consultation

Orthopaedic consultation

Key-hole  knee surgery

Key-hole knee surgery

Mr Wilson carrying out knee arthroscopy surgery

Mr Wilson carrying out knee arthroscopy surgery

Scrub team before ACL surgery

Scrub team before ACL surgery

Mr Wilson carrying out knee arthroscopy surgery

Mr Wilson carrying out knee arthroscopy surgery

ACL reconstruction in progress

ACL reconstruction in progress

Surgical team setting up for a knee replacement operation

Surgical team setting up for knee surgery

Mr Wilson preparing for knee osteotomy surgery

Mr Wilson preparing for knee osteotomy surgery

ACL reconstruction

ACL reconstruction

Arthroscopic knee surgery

Arthroscopic knee surgery

ACL reconstruction

ACL reconstruction

ACL surgery

ACL surgery

Knee osteotomy surgery in progress

Knee osteotomy surgery in progress

Anterior cruciate ligament reconstruction

Anterior cruciate ligament reconstruction