Knee Replacements
Why would I need a knee replacement?
You may need a knee replacement if you’re experiencing severe knee pain, stiffness, or decreased mobility that significantly affects your quality of life and ability to perform daily activities. Here are the most common reasons why knee replacement surgery might be recommended:
1. Severe Pain:
Chronic knee pain that doesn’t improve with conservative treatments like medications, physical therapy, or injections.
Pain that is persistent, even while resting or sleeping, and prevents you from doing basic activities, such as walking, climbing stairs, or getting in and out of chairs.
2. Limited Mobility:
A significant loss of range of motion in the knee, making it difficult or impossible to bend or straighten your leg fully.
Difficulty walking, standing, or getting up from sitting due to knee stiffness or instability.
3. Arthritis:
Conditions like osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis can cause the cartilage in the knee joint to wear away, leading to bone-on-bone contact. This causes pain, inflammation, and restricted movement.
Osteoarthritis is the most common reason for knee replacement surgery, as the cartilage that cushions the knee joint deteriorates over time.
4. Knee Deformity or Instability:
If your knee becomes deformed due to arthritis or an injury, such as a bowing of the leg or instability that causes it to give way, knee replacement can help restore alignment and stability.
A deformed knee may also put excessive pressure on certain parts of the joint, causing additional pain and difficulty moving.
5. Failure of Other Treatments:
When non-surgical treatments such as physical therapy, medications, injections, or lifestyle changes no longer relieve your symptoms or improve knee function, knee replacement may be considered as a last resort.
6. Quality of Life:
If knee pain or dysfunction significantly limits your ability to do the activities you enjoy or perform daily tasks (e.g., walking, driving, working, or participating in hobbies), knee replacement may be a way to regain a more active, pain-free lifestyle.
When pain and loss of function severely affect your emotional well-being or cause you to withdraw from social or physical activities, surgery can improve both physical and mental health.
7. Advanced Joint Damage:
If the damage to the knee joint is extensive, with severe wear and tear, deformity, or significant bone damage that cannot be repaired through other methods, knee replacement may be necessary to restore function and relieve pain.
8. Injury or Trauma:
A serious knee injury, such as a fracture or ligament damage, that doesn’t heal properly or causes long-term pain and instability may require knee replacement surgery, especially if there’s damage to the joint surfaces.
When is Surgery Considered?
Knee replacement is typically considered when:
You’ve tried conservative treatments, such as physical therapy, medications, and injections, without sufficient improvement.
The pain and dysfunction are so severe that they significantly impact your ability to carry out daily tasks or enjoy activities.
Your knee condition is affecting your overall quality of life and causing emotional or psychological distress.
Ultimately, the decision to have knee replacement surgery should be made in consultation with an orthopedic surgeon, who will evaluate the severity of your knee condition, review your medical history, and consider your personal goals for recovery.
What is a Knee Replacement?
A knee replacement is a surgical procedure in which a damaged or diseased knee joint is replaced with an artificial joint, known as a prosthesis. This surgery is typically done to relieve severe pain and improve mobility, usually after a person has experienced long-term knee issues from conditions like osteoarthritis, rheumatoid arthritis, or significant injuries.
The goal of the procedure is to reduce pain, improve function, and allow patients to resume daily activities with less discomfort. The replacement prosthesis is designed to mimic the natural movement of the knee joint, providing stability and support.
Types of Knee Replacements
There are several types of knee replacement procedures, depending on the extent of damage and the specific needs of the patient:
Total Knee Replacement (TKR) or Total Knee Arthroplasty (TKA):
Involves replacing the entire knee joint (both the femoral part and the tibial part) as well as the patella (kneecap) in some cases.
This is the most common type of knee replacement and is recommended when the entire knee joint is severely damaged.
Partial Knee Replacement (PKR):
Only the damaged portion of the knee joint is replaced. This is typically recommended when only one part of the knee is affected, such as the inside (medial) or outside (lateral) compartment of the knee.
Because it preserves more of the natural knee, recovery is often faster, and the outcome is typically more natural feeling than a full replacement.
Bicompartmental Knee Replacement:
This procedure replaces two of the knee’s three compartments (typically the medial and patellofemoral compartments).
This is a more conservative approach than a total knee replacement, but it still addresses more widespread damage than a partial knee replacement.
Unicompartmental Knee Replacement (UKR):
A more limited procedure where only one compartment of the knee (usually the medial or lateral side) is replaced.
Often recommended for patients with localised knee arthritis and good overall knee function. Recovery time is typically shorter than total knee replacement.
Complex or Revision Knee Replacement:
This is a type of surgery needed when an initial knee replacement fails, or when the knee prosthesis wears out or becomes loose.
It may involve replacing the components of the artificial joint or correcting issues with alignment or stability.
What are my options other than Surgery?
Not everyone needs or is eligible for knee replacement surgery. There are several non-surgical options to manage knee pain and improve function, particularly for people with mild to moderate joint damage. In cases of significant or severe damage with pain or limited joint range of motion, surgery is likely the only option to help releive your symptoms. Here are some examples of other options:
Physiotherapy:
Strengthening the muscles around the knee joint can improve support, reduce strain, and alleviate pain. Our Physiotherapists provide personalised programs to improve range of motion, stability, and function.
Medications:
Pain relievers: Speak to your GP or Consultant regarding safe over the counter or prescribed medication which you can take safely.
Topical analgesics: Creams or gels containing menthol or capsaicin can provide localised pain relief.
Injections:
Corticosteroid Injections: These injections can help reduce inflammation and provide temporary relief from pain and swelling in the knee joint.
Hyaluronic Acid Injections: These injections help lubricate the knee joint, improving joint movement and reducing pain.
Platelet-Rich Plasma (PRP) Injections: This involves using your own blood to inject healing factors into the knee joint, potentially stimulating tissue repair and reducing pain.
Bracing:
A knee brace can help provide support and stabilise the knee, reducing pain and improving function, particularly for patients with a specific compartment of the knee that is damaged (e.g., medial or lateral compartment).
Weight Management:
Maintaining a healthy weight reduces the pressure on the knee joints, helping to alleviate pain and prevent further damage, especially for those with knee osteoarthritis. There is strong evidence showing that even small amounts of weight loss can improve your pain and function.
Assistive Devices:
Using a walking stick, walkers, or other mobility aids can reduce pressure on the knee, making it easier to walk and reducing pain.
Lifestyle Modifications:
Modifying daily activities to avoid repetitive stress on the knee can prevent further damage. Low-impact exercises like swimming or cycling are ideal for maintaining fitness without aggravating the knee.
Stem Cell Therapy (Still Under Research):
In some cases, stem cell therapy has been proposed as a way to regenerate damaged tissues in the knee joint, though more research is needed to determine its effectiveness for osteoarthritis or other knee conditions.
TENS (Transcutaneous Electrical Nerve Stimulation):
This therapy involves the use of electrical impulses to help reduce pain and muscle spasms. It’s sometimes used as a conservative treatment for knee pain.
What Happens After a Total Knee Replacement?
The recovery process after a total knee replacement involves several stages:
Immediate Post-Surgery (Days 1-2):
Pain Management: Pain relief will be provided through medications, and ice packs may be used to reduce swelling.
Mobility: You’ll start with gentle movements and may begin to stand and walk using crutches or a walker.
Physiotherapy: You may start basic exercises to increase flexibility and strength.
Early Recovery (Weeks 1-4):
Physiotherapy: Continues to help restore range of motion and strengthen the muscles around the knee.
Wound Care: The surgical site will be monitored for signs of infection.
Swelling Management: Swelling will gradually decrease with proper care.
Full Recovery (Months 2-12):
Improved Function: You’ll regain strength, flexibility, and movement, but some discomfort may still occur.
Return to Activities: Low-impact activities like walking, swimming, and cycling may be reintroduced.
Continued Rehabilitation: To fully regain knee function, consistent physical therapy is essential.
Long-Term Outlook: Most people experience significant relief from pain, and the knee function improves significantly. Full recovery may take up to a year for some individuals.
Why Choose Home Visit Physiotherapy After Total Knee Replacement Surgery?
What Home Physio Company can do to help you
Home Physio Company has a fantastic team of specialist Musculoskeletal Physiotherapists providing mobile physiotherapy services. Home visit physiotherapy for a knee replacement is an extremely popular choice given the challenges that can come with getting to a clinic after surgery.
Personalised Rehabilitation Plan:
A physiotherapist can tailor exercises to your specific needs, ensuring that your recovery is effective and safe.
Convenience and Comfort:
Recovering at home can be more comfortable than going to a clinic, especially in the early days after surgery.
You can avoid the hassle of transportation and enjoy therapy in the comfort of your own space.
One-on-One Attention:
Home visits allow for more focused attention from your physiotherapist, as they can spend more time working with you on your specific issues, progress, and goals. We often use your home environment to complete your exercise program and go through each exercise so you feel confident completing your program independently.
Progress Monitoring and Adjustments:
The physiotherapist can monitor your recovery closely, checking for any complications such as infection, swelling, or poor movement patterns. They can also adjust the rehabilitation program as needed to prevent overexertion or under-rehabilitation.
Pain Management and Mobility Assistance:
The physiotherapist can help you manage pain through targeted techniques (e.g., manual therapy) and guide you on using assistive devices like crutches or walkers correctly.
Promoting Faster Recovery:
Early mobilisation and the right exercises, provided at home, can help speed up your recovery, reduce swelling, and restore knee strength and function more effectively.
Education and Support:
Physiotherapists educate you on what to expect during your recovery, teaching you how to move properly, reduce strain on the knee, and avoid re-injury.
In conclusion, private home visit physiotherapy can greatly enhance your post-operative experience, making recovery smoother, faster, and more efficient. It ensures that you're getting the care you need directly in your environment, improving both your physical and emotional well-being during the recovery process.
