Total Knee Replacement

    Total knee replacement is one of the most commonly performed orthopaedic operations and one of the most successful. Here is what it involves:-

Before the operation

    A pre-operative assessment visit to the hospital to check that you are fit to have surgery. This will include screening for MRSA, some blood tests and if necessary an ECG (heart trace) and a chest x-ray.

The operation

   You will be admitted on the morning of surgery having fully starved (nothing to eat or drink) from midnight the night before. You will be seen by the consultant anaesthetist and then by myself to complete a consent form and mark your leg (the consent form confirms the operation we are doing and the correct side; it also lists the principal risks that you should already be aware of: -

  1. Infection

  2. Thrombo-embolism

    The anaesthetic will usually take the form of an injection in your back (a spinal anaesthetic) to numb you below the waist (this will last for several hours) and then an injection to send you to sleep (sedation), but you can remain awake if you wish. The operation takes approximately one hour and is done through a cut over the front of the knee approximately 6-8 inches (16-20cms) long (when the knee is fully extended). The skin stitch is dissolvable and does not require removal.

After the operation

    Mobilisation under the supervision of a physiotherapist will begin on the day after surgery. You will probably be able to leave hospital 4 or 5 days after the operation by which time you will be walking with 2 sticks and able to go up and down stairs. The physiotherapy department will arrange to see and treat you once you as an outpatient.

    It is very common for the leg on the operated side to become swollen, sometimes markedly so. Generally this is nothing to be concerned about as you will be taking medication to minimise the risk of a thrombosis.

    We advise that you should not drive for a minimum of 4 weeks after surgery (if you have an automatic car this could be less if you have had surgery on the left knee). You will have an outpatient appointment to see me at the end of this period. (however, if there are any concerns regarding possible wound infection or thrombosis you should contact myself or the ward staff)

    Allow 6 weeks off work if you have a non-manual job and up to 12 weeks for a manual job (you will almost certainly feel more tired than you expect for the first 6 weeks).