Knee Replacement

Knee replacement, also called knee arthroplasty, is surgery that caps the worn surfaces of the knee joint with a smooth implant so the bones no longer rub painfully against each other. The damaged ends of the thigh bone and shin bone are reshaped and covered with metal components, and a strong plastic spacer sits between them to glide like healthy cartilage; the kneecap surface may also be resurfaced. In a total knee replacement the whole joint surface is renewed, while a partial replacement resurfaces only the single worn compartment when the rest of the knee is healthy. The implant restores a smooth, pain-free joint that supports the natural movements of walking, bending and standing.

Knee replacement is recommended when arthritis has worn the joint so far that pain and stiffness limit everyday life and simpler treatments no longer give relief. The most common cause is osteoarthritis, the age-related wearing of the smooth cartilage that lets the bones move freely, but the joint can also be damaged by rheumatoid and other inflammatory arthritis, by old fractures that disturbed the joint surface, or by previous joint infection. The key signs are constant or night-time knee pain, difficulty walking any useful distance, trouble climbing stairs or rising from a chair, and a knee that no longer responds to painkillers, weight management, physiotherapy or injections. Surgery is guided by how much the pain affects life, supported by an examination and X-rays, rather than by the scan alone.

Knee replacement is an open operation performed under spinal anaesthesia, where the patient is awake but feels nothing below the waist, or under general anaesthesia. Through an incision over the front of the knee the surgeon removes the worn cartilage and a thin layer of damaged bone, shapes the bone ends precisely and fixes the metal and plastic components in place, checking that the new joint moves smoothly and is well balanced before closing. The operation usually takes about 1 to 2 hours. Some teams use robotic or computer-assisted guidance to plan and position the implant accurately, but this is still carried out through the same open approach rather than a separate keyhole technique. A scar over the front of the knee is expected and fades over the following months.

A good candidate has knee arthritis that clearly limits daily life, has tried non-surgical care without lasting benefit and is well enough for anaesthesia and the recovery effort that follows. Preparation begins with an examination of the knee's movement, stability and alignment and with X-rays that show the degree of wear, alongside a general health check, blood tests and a heart trace where appropriate. Any other medical conditions, such as diabetes or high blood pressure, are brought under control, sources of infection like dental or urinary problems are treated first, and certain blood-thinning medicines are paused on medical advice. For international patients this can largely begin remotely from existing reports and scans, with the final assessment and anaesthetic review completed on arrival. Stopping smoking and strengthening the leg muscles beforehand both help recovery.

Recovery is active from the start. Most patients stand and take their first steps with support within a day of surgery, using a frame or crutches, and a physiotherapist guides exercises to restore movement and strength. The hospital stay is usually about 2 to 4 nights, and the wound is checked and the dressing changed before discharge. Walking improves steadily over the following weeks, most everyday activities return over about six weeks, and strength and confidence keep building over a few months. Planning a trip abroad, it is sensible to stay in the destination city for about 10 to 14 days so the wound can be checked, any stitches managed and safe walking confirmed before flying. Because long flights carry a clot risk after major joint surgery, the surgeon gives clear advice on timing, blood-thinning medicine and moving the legs in flight. Afterwards, follow-up continues remotely by message, photo or video, with interpreter and coordinator support, and routine checks and ongoing physiotherapy can be arranged near home.

Knee replacement is a safe and highly successful operation, and most patients gain lasting freedom from arthritis pain and a return to comfortable walking. As with any major surgery there are risks, including infection, bleeding, blood clots in the leg, stiffness, and over many years the gradual wear or loosening of the implant that can eventually need revision. These risks are kept low by careful planning, antibiotics, clot-prevention measures and a well-followed rehabilitation programme, which is why an experienced team and good aftercare matter so much. With committed physiotherapy most people regain a stable, pain-free knee that lets them walk, climb stairs and take part in everyday and gentle recreational activities for many years.