Knee Replacement

Knee replacement may be total, or partial. The decision is dictated by the severity of your condition. 

Preparation prior to surgery

• You will receive a thorough health assessment: including medical history. You may be advised to modify certain lifestyle factors and you may be referred to another specialist. You may be asked to stop taking certain medications as your surgery date approaches. X-rays, CT scans, and MRIs will be used to evaluate your condition and plan your surgery.  
• Skin and bowel preparation: On the evening before your surgery, you will be asked to wash your leg using the sponge provided at your pre-admission clinic. A skin test may be administered if an iodine allergy is suspected. You will also be provided medicine to help you evacuate your bowels prior to surgery.
• Patient education: if neccessary, you may speak with a physiotherapist who can advise you on post-operative mobility. 

On the day of the surgery

• You will be asked to complete your surgical paperwork and will meet with the anaesthetist.
• The surgical site will be prepared.
• You will be administered general or spinal anaesthesia.
• An incision is made to expose the knee joint. The damaged cartilage surfaces at the ends of the femur and tibia are removed along with a small amount of underlying bone.
• Specialised jigs are used to cut the femur and tibia. This process may utilise a surgical robot. Test components are inserted to assess this preparatory work.
• Bone or other material may be added where extensive bone loss occurs.
• If indicated, the undersurface of the kneecap may be cut and resurfaced with a plastic button.
• A plastic spacer is carefully inserted between the metal components to ensure a smooth, frictionless surface. 
• X-rays are taken to confirm positioining.
• The wound will be sutured and dressed.

After your surgery

• In-patient care: you will remain in hospital for several days for monitoring and early-stage rehabilition. 
• Pain and swelling: You may experience mild to moderate pain. You will be prescribed painkillers to manage these symptoms. Inflammation can be controlled by icing (15 minutes per hour maximum) and elevation.
• Mobilising: you will be encouraged to move the knee and walk within a day or two of surgery. You may require a walker or crutches until around 6 weeks post-surgery. By week 6, the knee should be able to bend to about 90 degrees, with a target range of 110-115 degrees. 
• Aftercare: at one week post-surgery, you will be required to attend a wound check and at two weeks your sutures will be removed. At 6 weeks, you will undergo further X-rays to assess healing, and at three months after your surgery for the same reason. You may be prescribed blood thinners to reduce the risk of a clot developing.