Things to consider before having knee replacement surgery

Written by: Professor Lee Jeys
Edited by: Robert Smith

Knee replacement surgery is becoming an even more common procedure than ever before. Whilst it’s usually performed on the elderly, young people occasionally have this procedure done too.



We spoke to leading orthopaedic surgeon Professor Lee Jeys, to find out what can be expected from knee replacement surgery, we found out the different types of knee replacement surgery, what some of the complications are and how they can be fixed.


What is the success rate of knee replacement surgery?

Total joint arthroplasty has shown to significantly improve function and a patient's quality of life in the long term. Studies show that 85% of patients consider their outcome as good or excellent and the risk of complications is relatively low.

Outcomes have been shown to be better in hospitals or with surgeons who perform a high volume of joint replacements.

What are the different types of knee replacement?

Most knee replacements in the UK are bicondylar, this resurfaces the femoral joint surface with a metal cap, the tibial joint surface with a metal and UHMWPE liner and some surgeons resurface the patella with a UHMWPE button. Established knee replacement designs have 95% 10-year and 85% 20-year implant survival results.

Unicompartmental or 'half' knee replacements are used if there is significant arthritis in the lateral or medial compartment, a functional anterior cruciate ligament, minimal deformity and in young patients. They replace the tibial surface and the posterior condyle of the femur on the affected side.

What are the main complications of knee replacements?

One of the major complications is infection, and superficial wound infections are common, with 5% requiring a course of antibiotics. If the wound remains infected there is a 20% chance of deep periprosthetic infection. The infection often forms a biofilm around the metallic implants making eradication very difficult.

The most common three problems following surgery are stiffness, pain and instability. At one year from surgery, 80% of patients are satisfied with the surgery and persistent pain is the most common reason for dissatisfaction. This group of patients need careful investigation to rule out instability, infection, patellofemoral pain or loosening.

However, if no treatable cause can be found, a conservative approach is more likely to offer pain relief rather than revision surgery. Postoperative stiffness is quite common following knee replacement and a poor range of motion and the inability to perform adequate rehabilitation. Excessive strains on the soft tissue and the implant itself can cause pain and the knee can potentially give way under the patient causing unsteadiness or falls.

How can potential complications be managed?

To help decrease pain levels and improve the range of motion manipulation under anaesthesia within six months from surgery can be done. Incorrect ligament balancing and pre-operative deformity or can result in the knee replacement becoming unstable and this would be amended.

Physiotherapy and revision surgery to a more constrained joint replacement are often required.

If you will require knee replacement surgery, we had a consultation with a highly experienced consultant orthopaedic surgeon such as Mr Lee Jeys. Click here to visit his Top Doctors profile for information on appointment availability.

By Professor Lee Jeys
Orthopaedic surgery

Prof Lee Jeys is a leading consultant trauma and orthopaedic surgeon in Birmingham who specialises in hip and knee surgery, including knee replacement, hip replacement and revision hip replacement surgery. He is also a specialist in the treatment of bone and soft tissue tumours.

Professor Jeys is one of the leading consultant surgeons at the Royal Orthopaedic Hospital, which is one of only five purely orthopaedic hospitals in the country. It has an international reputation as a centre of excellence.

Prof Jeys handles several hundred cases per year and is often lauded as an ‘international expert’ undertaking cases that others cannot do. He was recently recognised in the Daily Mail as one of the best knee replacement surgeons in the UK. He also takes a lead in paediatric surgery and regularly operates on children at regional paediatric hospitals.

He has published over 250 scientific papers in the world’s most important orthopaedic journals and he has written three chapters in textbooks about surgery. Professor Jeys was recently awarded the DSc for his thesis 'Improving Patient Outcomes by Innovation and Collaboration'. The DSc is the highest research degree in the UK and only awarded for individuals who make an outstanding contribution to their field. Professor Jeys regularly lectures around the world on joint replacement and tumour surgery.

He is involved with several national committees including being the former Chairman of the National Centre Research Institute (NCRI) for Sarcomas. He has worked with NICE, health technology appraisal boards, as well as several multinational companies. 

In 2018, Professor Jeys was voted as one of the best knee replacement surgeons in the country by his fellow consultants. You can read the Daily Mail article here.

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