Knee replacement is now more common even than hip replacement but remains a large operation and one where the best results are obtained by specialist surgeons, such as Mr. Miles.
The choice of when to operate is usually dependent upon the level of symptoms: specifically pain, loss of motion and stiffness. The choice of which operation will depend upon the degree of damage to the knee. If only a localised area is damaged, partial knee replacement is possible. In the majority of cases, there is more global cartilage loss throughout the knee and total knee replacement is advisable.
The operation is carried out through a vertical incision over the front of the knee; the areas of worn cartilage are excised and the surfaces replaced with metal. A polymer is then attached between the metal to act as a bearing surface. The alignment of the components is vital to function and long term survivorship so they must be carefully positioned. This can be done through either specific jigs or custom cutting blocks which can be manufactured pre-operatively.
After surgery, the typical hospital stay is 4-7 days, during which time therapists will aid in mobilising the knee and returning you to walking. The knee is usually sore and swollen for around six weeks after surgery.
The lnog term aim is a return to pain free movement. We work hard on range of motion in the early weeks to try to maximise bending; however, it is usually impossible to get absolutely full bend back after total knee replacement.
Recent advances have allowed for patient specific cutting blocks or implants to be used. There is an additional expense to these and some insurance companies will not necessarily cover all of the costs, depending upon your level of cover. Mr. Miles is supportive of these technologies and uses them in his NHS and private practices. If you need help with the insurance companies in these areas, please ask him and he will give you the appropriate details.