Total Knee Replacement

What it is

A total knee replacement (knee arthroplasty) resurfaces the worn ends of the thigh bone (femur) and shin bone (tibia), and often the underside of the kneecap, with metal and plastic components, recreating a smooth joint surface. It's most commonly performed for advanced osteoarthritis, though it can also address damage from rheumatoid arthritis or previous injury.

Who it's for

Knee replacement tends to be considered when pain, swelling and stiffness are consistently affecting sleep, walking distance and everyday tasks such as stairs, and when physiotherapy, activity adjustment, weight management, and pain relief are no longer providing enough benefit. Some patients are suitable for a partial (rather than total) knee replacement, which is discussed where relevant at consultation.

The procedure

Surgery generally takes around ninety minutes under spinal or general anaesthetic. The damaged joint surfaces are precisely reshaped and capped with implant components sized to your own anatomy. Enhanced recovery protocols, including targeted nerve blocks and early physiotherapy, are used throughout, with many patients standing and taking their first steps on the day of surgery.

For patients with a known metal sensitivity or allergy, nickel-free implant options are available.

Recovery

• Hospital stay: typically one to two nights.
• Walking aids: usually needed for four to eight weeks, tapering as strength and confidence return.
• Physiotherapy: regular knee-bending exercises from day one are central to a good outcome.
• Return to driving: generally around six weeks, once you have full muscle control.

Risks & considerations

Knee replacement is major surgery and carries risks including infection, blood clots, stiffness and the eventual need for revision as an implant wears. Recovery of full, comfortable knee bend can take longer than for a hip replacement, and this timeline is discussed honestly at consultation so expectations are realistic from the outset.