Consultant article: Why your knee replacement isn’t a knee replacement
Over the last decade, we’ve seen a huge leap forward in the success of knee replacement surgery.
In the hands of specialist, experienced knee surgeons, more than 90% of patients enjoy pain-free (or virtually pain-free) knees, allowing them to return to an active life.
Despite knee replacement being a relatively common procedure, it’s not well understood, which means virtually every conversation I have with patients starts by busting a few myths… myths like these:
'You’ll remove my knee?'
Every day I meet patients whose greatest concern is with that word ‘replacement’. Yet whilst the word conjures up images of the leg being ‘chopped’ above and below the knee, having the old knee removed and a new one swapped in, that’s not what happens at all.
Knee ‘replacement’ is really knee ‘resurfacing’. We remove only the worn-out surface of the bone above and below the knee and replace it with thin metal surfaces. Between the surfaces, a polyethylene spacer acts as a hard-wearing artificial cartilage.
'The only knee replacement is a total knee replacement'
Up to 50% of the patients I see who have symptoms bad enough to warrant knee replacement are suited to partial
knee resurfacing. These are patients who have wear on one side of the knee (wear on both sides will require a total replacement).
Partial knee resurfacing has several advantages over total knee resurfacing:
- Patients usually recover quicker (as the surgery is less invasive)
- Risks associated with surgery are reduced
- Recovery tends to be more complete as all the knee ligaments are preserved
'Knee replacements don’t last'
I’m often asked how long a knee replacement will take to wear out. Today 95% of implants last at least 10 years. Most last 15-20 years or more. Recently I’ve been part of a global team developing and trialling a new partial knee implant (Persona) that has features designed to increase the life of the implants even further.
'You’ll have to stop everyday activities'
Having a knee replacement doesn’t mean that you’ll need to give up pastimes you love. If you enjoy golf, social tennis, cycling, hiking, skiing and more, you should still be able to. Most patients say their knees (especially partial knees) feel ‘normal’ or ‘natural’ during activities.
Knee replacement (resurfacing) surgery has become phenomenally successful over the last decade or two. Risks still exist and should be balanced against the potential benefits, but resurfacing does enable most patients to live a normal life free from knee pain.
About Professor Nick London
Consultant Knee Surgeon Professor Nick London has 20+ years’ expertise in sports injuries, knee arthritis and knee ‘replacement’ surgery, working with patients including children, elite and amateur athletes, and older patients.
His Harrogate-based NHS practice has an excellent national reputation. In private practice, Nick works with The Yorkshire Knee Clinic at Nuffield Health Leeds Hospital. He is also a Visiting Professor at Leeds Beckett University. Read more about Prof Nick London