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Total Knee Replacement
In the UK more than 80,000 total knee replacements were performed last year, offering a highly successful treatment if you have painful osteoarthritis affecting your knees. Advances in the design and materials used for artificial knee joints, along with the fact that orthopaedic surgeons now practice on cadavers before operating, means that between 90 and 95% of patients benefit from good or excellent results for up to 15 years following knee replacement. Total knee replacement surgery is therefore now an established treatment if you have painful osteoarthritic knees that have not responded to conservative measures, such as lifestyle changes, medications and physiotherapy.
Comparison with Partial Knee Replacement Surgery While a total knee replacement provides a completely new knee joint, a partial knee replacement surgically replaces only one half of your joint. Mr John Hollingdale will decide whether a partial or total knee replacement is more appropriate in your case. A total knee replacement carries the advantage that it provides better relief from osteoarthritic pain and offers a longer lasting solution, making it a more suitable choice if you are younger. However, a total joint replacement does involve spending more time in hospital and a longer recovery period, so this will be taken into consideration when deciding which is the most suitable for you prior to your procedure in London. Like any surgical procedure, knee replacement carries risks so these, along with your current health and past medical history, will also be considered to make sure you are a suitable candidate for this surgery on your knee joint.
Total Knee Replacement Surgery Prior to surgery on your knees, it is necessary to assess your hip and ankle joints, as the health of these joints will determine the extent of the benefit you gain. Assuming there are no concerns about these adjacent joints and your routine blood tests and chest x-ray are clear, you will be ready for your surgery, performed by Mr John Hollingdale in London. However, it is important to be aware that if you are carrying excess body weight, this increases the likelihood of a poorer outcome following joint replacement, as your new knee may loosen or become dislocated. If you are overweight, losing weight before surgery is therefore advisable to enhance the results after the procedure.
During total knee replacement, the damaged or deteriorated surface of the thigh and shin bone at the knee joint is removed, using precise cuts to allow the prosthetic joint to be inserted at the correct angle. Mr Hollingdale uses NextGen artificial knee joints, manufactured by Zimmer from metal alloys and the plastic polyethylene, and they are available in a range of sizes, as this too is crucial to the success of the operation. Once in place, the prosthetic knee replacement is typically secured using modern bone cement, though where the prosthesis has a porous surface no cement is needed, as the bone simply fuses with the device.
The precision of total knee replacement is now aided by specialist surgical tools, termed surgical navigation systems, which reduce the risk of a misaligned knee prosthesis. More recently, patient specific instruments have helped the precision of joint fixation and prosthesis sizing, offering a custom-made approach to knee replacement, in much the same way that you would purchase a tailor-made suit in preference to buying one off-the-shelf. Since using these during the last two years, Mr Hollingdale has noticed a significant improvement in operation time and the accuracy of placing artificial knee joints. Mr Hollingdale has also improved patient outcomes by no longer using a tourniquet, which now reduces pain and improves mobility during the post-operative phase.
Recovery after a Total Knee Replacement Mobilisation is encouraged soon after this operation and following total knee replacement, physiotherapy is a key aspect of your rehabilitation, so you will usually start this the day following your procedure. Although a certain amount of discomfort and stiffness is inevitable during this therapy, the exercises you are taught are essential to strengthen your new knee joint and help you to resume normal mobility quicker, so even once you are home it is important to continue with your physical therapy.
You will also be provided with after care instructions for home and it is vital that you attend your follow-up appointments with Mr Hollingdale to review your progress, which further enhances your chance of a successful outcome.