Understanding the Ins and Outs of Knee Surgery

Knee surgery is a common procedure for individuals suffering from knee pain, injury, or chronic conditions like osteoarthritis. Whether you’re considering surgery to improve mobility or alleviate pain, a better understanding of knee surgery that covers the different types of knee surgeries, the recovery process, and what to expect throughout your treatment journey is essential.

This article will walk you through the key aspects of knee surgery, providing you with the information needed to make informed decisions and navigate your recovery.

1. Why Do People Need Knee Surgery?

The knee is a complex joint that plays a crucial role in day-to-day movement. It is a hinge joint where the femur (thigh bone) meets the tibia (shin bone), with the patella (kneecap) protecting the joint in the front.

Over time, or due to trauma, several conditions can lead to the need for knee surgery.

Whilst knee surgery is available on the NHS, waiting times are invariably quite long. This not only means living with pain and immobility issues, but can also mean the condition deteriorates requiring a more complex operation and possibly longer recovery times.

For those who are able to do so, private knee surgery is an option worth considering for those who are suffering from knee pain and limited function due to the following conditions:

● Osteoarthritis: A degenerative joint disease that causes cartilage to wear down, leading to pain, stiffness, and decreased mobility.
● Meniscus Tears: Damage to the meniscus, a cartilage disc that cushions the knee joint, often occurs due to sports injuries or age-related degeneration.
● Ligament Injuries: Injuries to the ligaments, such as the anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL), can require surgical intervention for stability and function.
● Patellar Disorders: Conditions affecting the kneecap, such as patellar dislocation or maltracking, may require surgery to realign or stabilize the joint.
● Fractures: Fractures in the bones around the knee, such as the femur, tibia, or patella, may require surgical repair.

Knee surgery aims to relieve pain, restore function, and improve the quality of life for individuals struggling with knee problems.

2. Types of Knee Surgery

A better understanding of the several different types of knee surgery is also important as each is designed to address different conditions and injuries. The choice of surgery depends on the severity of the issue, the patient’s health, and their activity level.

Arthroscopy (Minimally Invasive Surgery)

Knee arthroscopy is one of the most common and minimally invasive knee surgeries. It involves making small incisions and inserting a tiny camera (arthroscope) to view the joint. Surgeons can then repair or remove damaged tissue, such as torn meniscus or damaged cartilage, through additional small incisions.

● Advantages: Shorter recovery time, minimal scarring, and less risk of complications.
● Recovery: Patients usually experience faster recovery and can often return to light activities within a few weeks.

Knee Replacement Surgery (Total and Partial)

Knee replacement surgery, also known as arthroplasty, is typically recommended for individuals with advanced osteoarthritis or significant joint damage. There are two main types:
● Total Knee Replacement (TKR): Involves replacing the entire knee joint, including the femur, tibia, and patella, with artificial components.
● Partial Knee Replacement (PKR): Only the damaged part of the knee is replaced, leaving healthy tissue intact.

● Advantages: Significant pain relief and improved mobility for patients with severe knee arthritis.
● Recovery: TKR typically requires a longer recovery period than partial knee replacement, with patients often needing physical therapy for several months.

Ligament Repair or Reconstruction

Knee surgeries to repair or reconstruct torn ligaments, such as the ACL or PCL, are common for athletes or active individuals who sustain ligament injuries. These procedures typically involve using a tendon from another part of the body or from a donor to replace the damaged ligament.

● Advantages: Restores knee stability and allows individuals to return to their pre-injury activity level.
● Recovery: Recovery can take several months, with extensive physical therapy required to rebuild strength and mobility.

Realignment Surgery (Osteotomy)

For patients with knee misalignment or joint deformities, an osteotomy may be performed. This procedure involves cutting and realigning the bones around the knee to relieve pressure and redistribute weight across the joint.

● Advantages: Can delay or prevent the need for a total knee replacement, especially in younger patients.
● Recovery: Recovery time can be lengthy, as it involves bone healing and rehabilitation to restore function.

3. What to Expect Before Knee Surgery

Before undergoing knee surgery, it’s important to undergo a thorough evaluation by your surgeon. They will assess your condition through physical exams, imaging studies (X-rays, MRIs), and sometimes blood tests. Based on the results, the surgeon will recommend the most appropriate type of surgery.

● Preoperative Instructions: You may need to stop taking certain medications, such as blood thinners, in the days leading up to the surgery. You may also be asked to fast for several hours before the procedure.
● Anesthesia: Knee surgery is typically performed under general anesthesia or regional anesthesia (where only the lower body is numbed). Your anesthesiologist will discuss the best options for you.
● Consultation with a Physical Therapist: Some surgeons recommend meeting with a physical therapist before surgery to understand the rehabilitation process and to learn pre-surgery exercises that can aid in recovery.

4. The Surgical Procedure

Knee surgery is performed in a hospital or surgical centre, and the duration depends on the type of surgery being performed:
● Arthroscopy: The procedure may take anywhere from 30 minutes to 1 hour, depending on the complexity of the issue.
● Knee Replacement: Total knee replacement surgery usually takes around 2-3 hours.
● Ligament Reconstruction: ACL or PCL reconstruction surgery typically takes 1.5 to 2 hours.
While you are under anesthesia, the surgeon will perform the necessary repair or replacement. Afterward, you will be monitored in a recovery room as the anesthesia wears off.

5. Post-Surgery Care and Recovery

Recovery after knee surgery varies depending on the type of procedure performed, your overall health, and your adherence to rehabilitation. Here are some general guidelines:

Immediate Post-Surgery

● Pain Management: Pain relief is an important part of recovery, and your doctor will prescribe pain medication. Cold compresses and elevation can help manage swelling.
● Wound Care: Keep the surgical site clean and dry to avoid infection. Your doctor will provide guidance on when you can shower and change your dressings.
● Mobility Aids: For some surgeries, you may need crutches, a walker, or a knee brace in the initial stages to assist with mobility and prevent putting too much weight on the knee.

Physical Therapy

Physical therapy is a key component of knee recovery. Your therapist will work with you to regain strength, flexibility, and mobility. Sadly, follow-up appointments and the rehabilitation process is often somewhat erractic within the NHS systems. Understanding the type of rehab needed post knee surgery is essential.

Rehab focuses on:
● Range of motion exercises to prevent stiffness.
● Strengthening exercises to rebuild muscle around the knee.
● Balance and coordination training to improve stability.

Follow-Up Appointments

Regular follow-up appointments with your surgeon are essential to monitor your progress. During these visits, the surgeon will check for signs of infection, ensure proper healing, and may adjust your rehabilitation program based on your recovery.

6. What to Expect During Recovery

Recovery time varies based on the procedure:
● Arthroscopy: Recovery from knee arthroscopy can take anywhere from a few days to a few weeks, with most people resuming normal activities within 1-2 weeks.
● Knee Replacement: Recovery from total knee replacement usually takes 6 to 12 months for full recovery, although patients typically start walking with assistance within a few days to a week.
● Ligament Surgery: The recovery for ACL or other ligament surgeries can take 6 to 9 months, with athletes returning to sports around 9 months to a year.
● Osteotomy: Full recovery from an osteotomy can take 4 to 6 months, depending on the extent of the procedure.

7. Potential Risks and Complications

As with any surgery, knee procedures come with potential risks, including:
● Infection: Proper wound care and adherence to hygiene instructions can minimize the risk of infection.
● Blood Clots: Blood clots can form after surgery, especially in the legs. Your doctor may prescribe blood thinners or suggest leg exercises to reduce this risk.
● Stiffness or Limited Range of Motion: Some people may experience stiffness or difficulty moving the knee joint. Regular physical therapy and stretching can help mitigate this.
● Nerve Damage: Although rare, nerve damage can occur, leading to numbness or weakness.

8. Long-Term Outlook

For many patients, knee surgery is life-changing, providing long-term relief from pain and improved functionality. However, it’s important to manage expectations and understand that full recovery can take time. Patience, commitment to rehabilitation, and following your doctor’s advice will be crucial for a successful outcome.

Whether you’re recovering from a meniscus tear, ligament injury, or knee replacement, understanding the ins and outs of knee surgery will help you prepare mentally and physically for the recovery process.

With the right approach and support, and a better understanding of knee surgery with everything that entails, you can look forward to a return to an active, pain-free life.