In the know about knee replacements

Written by: Mr Stephen Veitch
Edited by: Karolyn Judge

When it gets to the point that a knee replacement becomes the only option, it might feel good to know that relief is more than likely it’s on its way - but also nerve-wracking in regards to going through the operation.


Here to shine a light on when the procedure is required, revision knee replacements and how successful knee replacements are, among other interesting points, is leading orthopaedic hip and knee surgeon in Salisbury, Mr Stephen Veitch.

Man who needs a knee replacement holding his knee


When is a knee replacement required?

A knee replacement should be considered for patients with significant pain and limited function due to knee arthritis, when non-surgical options such as pain medication are no longer controlling their symptoms.



How many knee replacements might a person need in their lifetime?

For the vast majority of patients, a single knee replacement will be all they need. The average survivorship of a knee replacement is 25 years. In a very small number of patients a further knee replacement (revision) may be necessary.

The reasons for this can be:

  • Due to implant loosening from wearing of the implant;
  • Progressive arthritis if a partial knee replacement is used;
  • Infection;
  • Fracture causing loosening and instability when the replaced knee regularly gives way.



How is it performed?

The operation is performed under a spinal and/or general anaesthetic. The skin is coated in antiseptic and the leg covered with sterile drapes, the incision is made at the front of the knee, the knee cap (patella) is moved to one side and the knee joint is exposed. Alignment jigs are used to ensure accurate sizing and positioning of the implants. Cuts are made removing any remaining cartilage and a small amount of bone in such a way to allow the implants to be seated in position.


Initially, trial implants are used to confirm that the knee fully straightens and bends smoothly, the patella tracks smoothly and the knee is stable. The definitive implants (cobalt chrome metal alloy) are then cemented into the bone using bone cement and the polyethylene liner inserted. If the patella cartilage is worn then the cartilage is removed and resurfaced with a cemented polyethylene implant at the same time.


The knee is washed with sterile saline, local anaesthetic injections performed around the deep and superficial tissues. Then the knee is closed in layers with sutures and a dressing is applied.


How successful are knee replacements?

The majority of patients are very pleased with the pain relief and their quality of life following a knee replacement. The knee can be uncomfortable and swollen for the first three months after surgery. In a small number of patients, the knee takes a longer time than usual for pain, swelling and stiffness to improve.



What are the most commonly reported side effects of knee replacements?

Stiffness and swelling; particularly in the first three months. Occasionally the knee can remain uncomfortable during the first year. A small area of skin on the outer aspect of the knee next to the incision can lose its sensation. However, this skin loss is rarely troublesome for patients.



If you would like an assessment for a knee replacement or are experiencing pain that requires treatment, make an appointment with Mr Veitch via his Top Doctors profile.

By Mr Stephen Veitch
Orthopaedic surgery

Mr Stephen Veitch is a highly-experienced consultant orthopaedic hip and knee surgeon based in Salisbury, serving Wiltshire, Dorset and Hampshire. With over 10 years’ experience as an orthopaedic consultant surgeon, Mr Veitch is highly skilled in a number of procedures, including hip, knee and joint replacements, revision hip and knee surgery, knee arthroscopy, joint injections and meniscal debridement.

Mr Veitch has extensive experience in his field, routinely helping patients who suffer from knee and hip pain. He is an expert in hip and knee disorders and lower limb reconstruction. Another of Mr Veitch’s areas of expertise is soft tissue injuries, including hip and knee, ligament and tendon, and muscular injuries.

Mr Veitch received his MB ChB from the University of Sheffield in 1996. He then completed his basic surgical training in Sheffield, and was awarded his MRCS from the Royal College of Surgeons of England in 2000. He also received a Doctorate of Medicine (MD) from the University of Sheffield in 2005, writing his thesis on changes in bone metabolism following tibial fracture.

In 2007, he was awarded an FRCS (Tr & Orth) from the Royal College of Surgeons of England. In 2010, he became a consultant trauma and orthopaedic surgeon at the Salisbury District Hospital, before going on to become Clinical Lead from 2016-2019.  

Over the course of his career, Mr Veitch has also undertaken a number of surgical fellowships, including a fellowship in complex hip replacement and revision surgery at the Llandough Hospital in Cardiff, and a fellowship in hip and knee surgery at Derriford Hospital, Plymouth.

Mr Veitch has an impressive academic background, having published numerous academic articles in peer-reviewed journals. He has also spoken at various national and international conferences.

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