Knee Replacement Physiotherapy in London and Essex

Tuesday 7th November 2023

Gemma B

Knee Replacement Physiotherapy in London and Essex

What is a knee replacement?

A knee replacement is a surgical procedure, which involves replacing a knee joint with an artificial joint, also known as a prosthesis. This could be on the inside (medial), outside (lateral) or both, it depends on the extent of damage and persons goals.

Occasionally, a patellofemoral knee replacement is done. This is a procedure that replaces the worn knee cap (patella) and the groove at the end of the thigh bone (trochlea).

What are the indications for a knee replacement?

Osteoarthritis, Rheumatoid arthritis, deformity and post-traumatic arthritis are the most common indications for surgery. Severe pain, deformity and limited function are the key indicators of further investigations. X-rays can help to evaluate the condition of the cartilage. Some surgeons also order an MRI scan.

What does the surgery involve?

Before the surgery, you will undergo a thorough assessment of your overall health and appropriateness for surgery. Your surgeon will discuss the risks, benefits and expected outcomes.

Knee surgery is normally performed under general anesthesia, this is to make you feel comfortable. Occasionally, regional anaesthetic is used instead, such as a spinal or epidural block.

Once you are under anesthetic, an incision will be made over the joint. The damaged joint surfaces are removed and replaced with artificial components. This replicates the shape and function of the individual's healthy knee. The surgeon will then close the incision, normally with sutures or staples.

Following the surgery, you will be taken to a recovery area where you will be closely monitored. Pain management, wound care and Physiotherapy will start on the ward in the hospital. The operation should be regarded as just the first step in a long road towards regaining function of the knee.

What might my recovery look like?

Hospital:

After surgery, you will typically stay in the hospital for a few days. During this time, a multidisciplinary team will help manage your pain, monitor your health, give you tips on how to regain your independence and help you exercise. These exercises are essential for regaining your strength and flexibility. You will also be given guidance on how to get in and out of bed, using any new walking aids and how to walk up and down the stairs. It is likely that the surgeon will want to see that your knee can bend to 90 degrees before going home.

Home:

You must continue to follow the guidance you were given on medication, wound care and Physiotherapy exercises. Swelling, stiffness and discomfort is normal during this period. Your surgeon will follow you up to monitor your progress, assess healing and make further recommendations on your treatment plan.

A Physiotherapist may support you at home by tweaking the exercises, as well as working on joint and soft tissue mobility. The Physiotherapist may also recommend exercising in water. The number of sessions needed is dependent on your range and function to start with and the speed of your progress. Private Physiotherapy can work alongside NHS Physiotherapy or knee replacement classes.

The healing process takes time and the post-operative rehabilitation is tough and should not be underestimated. It is worth noting that knee implants may not provide the same feel or performance characteristics experienced with a normal healthy joint.

What complications are there?

The likelihood of experiencing complications varies from person to person. The vast majority of knee operations occur without any problems and your surgeon can provide you with further information on how likely these are to happen to you. Here are some potential complications that can occur:

Infections can develop in the surgical site. This can be superficial or deep. Certain health conditions and malnutrition may increase your risk of developing an infection. If an infection occurs, you may require antibiotics and in some cases surgery will be needed.

Blood clots may form in the veins of the leg after surgery. Medications and pneumatic compression stockings may be used to reduce this risk. The main way of preventing a blood clot is to get up and move as well as doing your exercises. The implant can become loosened, dislocate or wear over time, which may need revision surgery to resolve.

Limited range of motion. Typically, exercise or manual therapy will help if this is a problem. However, some people need further input by the consultant.

Damage to the nerves or blood supply during the surgery may lead to sensation changes. This normally resolves over time but sometimes needs a specialist opinion. Although surgery is intended to alleviate pain, occasionally people end up with persistent pain.

How long will my recovery take

It is worth noting that a partial knee replacement has several advantages over a total knee replacement, including shorter recovery time and more range of motion preserved after surgery.

The majority of people are walking short distances using a mobility aid and doing the stairs, within a few days of the operation. The average time before returning to work is nine weeks. If you have a sedentary job, this may be as short as four weeks. Returning to sport, full strength and function of the knee is likely to take months. Your consultant will be able to guide you when you are safe to return to driving, work or sporting activities.

It is important to not compare yourself to others during the recovery process. It is influenced by many factors. It is important to report any concerns you have to your healthcare provider early so you can get the appropriate tailored guidance.

Booking an appointment

If you would like to find out more about Estuary Physios Orthopaedic service, please get in touch with us today and speak with one of our clinicians.

Helpful Resources

NHS - Knee Replacement

Escape-pain.org

Versus Arthritis.org

Other Conditions we treat:

We understand that our clients often have a range of medical conditions. Our therapists have a broad range of backgrounds. For example, someone with joint replacement may also find they are having difficulty with back pain. We have specialist musculoskeletal therapists who can work alongside an Orthopaedic Physiotherapist to get the best results. Here are some other conditions we treat here at Estuary Physio:

Back, neck and joint pain

Medical Review

The information on this page has been reviewed for accuracy by Barry Ford BSc MCSP, Physiotherapist