Knee Replacement in Northampton

Knee replacement is indicated in cases of severe joint damage, usually as a result of arthritis, which is causing very significant pain and poor quality of life. If your specialist recommends this option to you, you will have failed to respond to simpler types of treatment

Partial Knee Replacement

partial-knee-replacement-oxford

 (left) Patellofemoral Knee Replacement. (right) Oxford Unicompartmental Knee Replacement

Where the damage to the knee joint is localised to just one part of the knee, a ‘partial’ knee replacement may be performed. This involves removal of the damaged area and replacement by artificial surfaces made of metal alloy and high density plastic.

The commonest form of this type of knee replacement is the ‘Oxford Unicompartmental Knee Replacement’, or UKR for short. Where the kneecap joint alone is affected, it may also be resurfaced using a ‘Patellofemoral Replacement’. The unaffected areas of the knee are therefore retained.

These techniques are performed through a smaller cut in the skin than a full (total) knee replacement, the patient often recovers a little faster, and may gain a better range of movement than with a Total Knee Replacement (TKR).

Total Knee Replacement

Image shows X-ray of a Total Knee Replacement Front  Side

(Left) X-ray of a Total Knee Replacement from front and side             (right) The PFC Total Knee Replacement

This involves removal of the damaged joint surfaces and replacement with new metal components which are shaped to fit the ends of the bones (the femur and tibia). A strong plastic disc is inserted between the two components, forming a new joint surface.

About the Operation

Once the decision has been made to go ahead with surgery, you will need to attend the hospital for pre-operative assessment a couple of weeks before your surgery date. These tests will ensure that you are physically fit for surgery, and also that you are free of any germs on your skin or in your urine which might put you at risk of developing an infection after your operation. MRSA is screened for routinely, and surgery will only proceed if you are not carrying this germ on your skin.

The anaesthetist will explain the details of your anaesthetic and ensure that you are comfortable after the operation. Usually a spinal (‘epidural’) anaesthetic is recommended, but a full general anaesthetic may be advised in certain cases. You may require a blood transfusion after surgery.

Your surgeon will see you each day following the operation. The nurses and physiotherapists have extensive experience in helping patients to recover from knee replacements, and will ensure that you are safe walking independently with sticks and can manage stairs before allowing you home. It is usual to stay in hospital between three and five days, but some patients get home a little sooner.

The skin staples are removed after 10-12days, until which time the wound must be kept dry

You will be given some exercises to perform at home over the next few weeks, often requiring some supervision by a physiotherapist if your knee is particularly stiff. You will be followed up in the outpatient clinic six weeks after the surgery, when your surgeon will check on your progress. Return to driving a car and non-manual work is usual by this stage.

knee-replacement-revision

If a knee replacement wears out over time it may need to be revised. The risk of this being requires over the first ten years following primary knee replacement is in the order of 2-3%.

Thereafter, you will increase your activities gradually, improving your range of movement and confidence in your new knee. The knee bend often continues to improve for up to 12 months following the surgery.

Possible Complications

Knee replacement of any type is a major operation and as such carries a small but significant risk of complications. These include infection, stiffness, and deep vein thrombosis (DVT). Other risks are discussed in detail with you by your surgeon in the clinic. You will be able to ask questions, and are given a copy of the consent form which you will sign to show that the operation has been explained to you fully. It is, after all, ultimately your decision whether or not to proceed with surgery.

How long will my new knee last?

This will vary depending on the amount of activity it has to withstand and in particular the amount of weight it must support. If you are of average build and your activities involve unlimited walking but no impact-loading sport, your new knee should last well in excess of ten years.