Knee replacement overview

Overview

Knee replacement is a surgery to replace a damaged or worn-out knee joint with an artificial one. It is usually done when knee pain and stiffness make daily activities very difficult, and other treatments have not helped enough.

Yes, knee replacement is a common and established surgery. It is one of the most successful joint replacement procedures.

It typically affects people with severe knee arthritis, especially osteoarthritis, but also those with rheumatoid arthritis or knee injuries that have worn down the joint over time.

Symptoms

Common symptoms

• Severe knee pain that makes walking, climbing stairs, or getting up from a chair hard.
• Stiffness in the knee, especially after sitting for a while.
• Swelling or tenderness around the knee joint.
• A grinding or clicking feeling when you move the knee.
• The knee may feel unstable or give way.

Symptoms in children

• Knee replacement is rarely done in children. Symptoms of severe knee problems in a child could include persistent pain, limping, or swelling after an injury.

Symptoms in older adults

• In older adults, the same symptoms are common, but stiffness and pain may be worse in the morning or after rest.
• Older adults may also have other health conditions that affect recovery, so doctors evaluate carefully.

Causes

Main causes

• Osteoarthritis: the most common cause, where the protective cartilage on the ends of bones wears down over time.
• Rheumatoid arthritis: an autoimmune condition where the joint lining becomes inflamed and damages the cartilage.
• Previous knee injury, such as a fracture or torn ligament, that leads to joint damage years later.

Risk factors

• Getting older (over 50).
• Being overweight or obese, which puts extra pressure on knee joints.

When to see a doctor

See a doctor urgently if:

• You cannot bear any weight on your knee.
• Your knee looks deformed or is very swollen after an injury.
• You have a fever and your knee is red, hot, and swollen.

Book a routine appointment if:

• Knee pain that has not improved after trying rest, ice, and over-the-counter pain relievers for several weeks.
• Stiffness that makes it hard to get through daily tasks like shopping or walking.

Diagnosis

A doctor will ask about your symptoms, examine your knee, and may order imaging tests to see the condition of the joint. They will also review your overall health to decide if surgery is safe.

Tests that may be done

• X-rays: to show bone and joint space narrowing.
• MRI scan: to get a detailed look at soft tissues like cartilage and ligaments.
• Blood tests: to check for signs of infection or other types of arthritis.

What to expect at your appointment

The diagnosis process is straightforward. Your doctor will explain the findings and discuss whether knee replacement is likely to help you. They will also talk about non-surgical options you can try first.

Treatment

Treatment for severe knee arthritis starts with non-surgical methods. If these don't give enough relief, knee replacement surgery may be considered. The goal is to reduce pain and improve movement.

Self-care at home

• Rest when your knee hurts and apply ice packs for 15-20 minutes a few times a day.
• Do gentle leg exercises to keep muscles strong, as recommended by a physiotherapist.
• Lose weight if needed, to take pressure off the knee.
• Use a walking stick or crutch for support during flare-ups.

Medical treatments

Doctors may suggest over-the-counter or prescription pain relievers (like paracetamol or anti-inflammatory gels) to manage pain. They may also recommend physiotherapy to strengthen the muscles around the knee. Sometimes, steroid injections into the knee joint can provide temporary relief. All these are tried before discussing surgery.

Living with this condition

After knee replacement, recovery takes several weeks to months. You will need to do daily exercises to regain movement and strength. Most people can walk without a cane after 2-3 months and return to normal activities like shopping, swimming, and driving after 6-8 weeks, but full recovery can take up to a year.

Lifestyle tips

• Avoid high-impact activities like running or jumping – stick to walking, cycling, or swimming.
• Keep a healthy weight to protect your new knee.
• Follow your surgeon's advice about when you can bend, squat, or kneel.

Diet and exercise

Eating a balanced diet with plenty of protein and calcium helps healing. Gentle exercises like walking and leg stretches are encouraged. A physiotherapist will give you a personalized exercise plan.

Mental health and emotional wellbeing

Having knee replacement can be stressful. You might feel anxious about surgery or frustrated with the slow recovery. It's normal to feel down sometimes. Talk to your doctor or a counsellor if you need support. Remember, most people feel much better after they recover.

Prevention

Knee arthritis cannot always be prevented, but you can reduce your risk by maintaining a healthy weight, staying active with low-impact exercise, and avoiding knee injuries. Once the joint is severely damaged, knee replacement may be needed.

Vaccines

There are no vaccines for knee arthritis. However, staying up to date with vaccines, like the flu and pneumonia vaccines, is important before surgery to reduce infection risk.

Screening programmes

There is no routine screening for knee arthritis. Your doctor will check your knees during regular check-ups if you have symptoms.

Complications

If left untreated

• Chronic pain and stiffness can get worse over time.
• You may become less active, which can lead to weight gain, muscle weakness, and other health problems.
• The joint may become more deformed or unstable.

Long-term outlook

Knee replacement is a very successful surgery. Over 90% of people have reduced pain and better movement. The artificial joint usually lasts 15-20 years or more. With proper care, you can return to a more active and comfortable life. Talk to your surgeon about what to expect for your individual situation.

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