Things to consider before having knee replacement surgery
Written by: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 per cent 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.
