Non-operative management
Managing knee arthritis without surgery aims to alleviate pain, improve function, and enhance overall well-being. This approach is Riaz’s preferred method until symptoms are severe enough to warrant surgery or conservative options have proven ineffective. Treatment typically includes:
- Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) and Panadol Osteo to reduce pain and inflammation.
- Physical Therapy: Tailored exercises to strengthen the muscles around the knee and maintain flexibility.
- Lifestyle Modifications: Weight management and participation in low-impact activities, such as swimming or cycling.
- Assistive Devices: Knee braces to provide additional support.
- Injections: Cortisone ± hyaluronic acid injections (HLA) can provide relief for weeks to months. If successful these may be repeated.
- Alternative Therapies: Acupuncture and nutraceuticals can offer additional pain relief.
- Patient Education and Support: Empowering individuals with knowledge and access to support networks to manage their condition with confidence.
This comprehensive approach helps in managing symptoms effectively and improving quality of life.
Partial Knee Replacement
This surgery aims to alleviate pain caused by localized damage to either the medial (inner side) or lateral (outer side) compartment of the tibiofemoral joint, which is the main joint of the knee bone. Osteoarthritis is the primary cause of damage to one side of the knee joint surfaces.
Partial (or unicompartmental) knee replacement surgery focuses on resurfacing the affected portion of your knee joint, typically the inner side, with an artificial joint. This procedure is less invasive than a total knee replacement, as it involves removing less bone and preserving all the ligaments.
DO YOU NEED SURGERY
Partial (or unicompartmental) knee replacement is a suitable surgical option if damage is confined to only one side of the knee joint. It typically offers a shorter recovery time compared to a total knee replacement. Riaz will assess your condition and help determine if and when this surgery is appropriate for you.
WHAT HAPPENS DURING SURGERY
A surgical incision is made at the front of the knee. The knee muscles are carefully split and pulled aside to allow Riaz to access and assess the extent of damage within the joint. The damaged bone surfaces on one side of your thighbone and shinbone are removed and replaced with artificial surfaces made of metal. A plastic liner is then placed between the new metal components. The skin incision is typically closed with medical adhesive (superglue).
WHAT COULD GO WRONG
The potential risks associated with partial knee replacement are similar to those of a total knee replacement but are generally less likely to occur. These risks include deep infection in the joint, blood clots, injury to nerves or blood vessels, delayed wound healing, ongoing knee pain, and risks related to anesthesia. Additionally, if arthritis develops in the areas that were not replaced, you may require further surgery in the future. In Riaz’s hands 90% of partial knee replacements last 12 years or longer (see figure 22 + 26)
It is crucial to discuss these risks and any concerns you may have with Riaz before proceeding with the surgery.
PARTICIPATING IN YOUR REHABILITATION
Preparation for recovery starts before your surgery. Maintaining a healthy body weight is crucial, as being overweight increases stress on the knee and surgical risks. Aim to achieve a healthy weight, stay active, and strengthen your knee muscles in the lead-up to the surgery.
Your hospital stay will likely be 3-5 nights. Physiotherapy may start on the day of or the day after the surgery, with goals including managing swelling, minimizing pain, regaining knee movement, walking with crutches, and climbing stairs. Some knee pain and stiffness are normal during the initial months. Stay engaged and positive during therapy, and diligently perform your home exercises for the best recovery outcomes.
BENEFITS YOU CAN EXPECT
After surgery, 96% of patients who were able to walk without assistance before the procedure are able to do so again within less than 3 months. Additionally, 90% of our patients are either pain-free or experience only mild pain (less than 3 out of 10) one year after the operation, and 89% report good knee function, as indicated by an Oxford Knee Score (OKS) greater than 34.
The typical expectation is that most patients will achieve significant pain reduction and reach full recovery within 12 months post-surgery.
DO YOU NEED SURGERY
Partial (or unicompartmental) knee replacement is a suitable surgical option if damage is confined to only one side of the knee joint. It typically offers a shorter recovery time compared to a total knee replacement. Riaz will assess your condition and help determine if and when this surgery is appropriate for you.
WHAT HAPPENS DURING SURGERY
A surgical incision is made at the front of the knee. The knee muscles are carefully split and pulled aside to allow Riaz to access and assess the extent of damage within the joint. The damaged bone surfaces on one side of your thighbone and shinbone are removed and replaced with artificial surfaces made of metal. A plastic liner is then placed between the new metal components. The skin incision is typically closed with medical adhesive (superglue).
WHAT COULD GO WRONG
The potential risks associated with partial knee replacement are similar to those of a total knee replacement but are generally less likely to occur. These risks include deep infection in the joint, blood clots, injury to nerves or blood vessels, delayed wound healing, ongoing knee pain, and risks related to anesthesia. Additionally, if arthritis develops in the areas that were not replaced, you may require further surgery in the future. In Riaz’s hands 90% of partial knee replacements last 12 years or longer (see figure 22 + 26)
It is crucial to discuss these risks and any concerns you may have with Riaz before proceeding with the surgery.
PARTICIPATING IN YOUR REHABILITATION
Preparation for recovery starts before your surgery. Maintaining a healthy body weight is crucial, as being overweight increases stress on the knee and surgical risks. Aim to achieve a healthy weight, stay active, and strengthen your knee muscles in the lead-up to the surgery.
Your hospital stay will likely be 3-5 nights. Physiotherapy may start on the day of or the day after the surgery, with goals including managing swelling, minimizing pain, regaining knee movement, walking with crutches, and climbing stairs. Some knee pain and stiffness are normal during the initial months. Stay engaged and positive during therapy, and diligently perform your home exercises for the best recovery outcomes.
BENEFITS YOU CAN EXPECT
After surgery, 96% of patients who were able to walk without assistance before the procedure are able to do so again within less than 3 months. Additionally, 90% of our patients are either pain-free or experience only mild pain (less than 3 out of 10) one year after the operation, and 89% report good knee function, as indicated by an Oxford Knee Score (OKS) greater than 34.
The typical expectation is that most patients will achieve significant pain reduction and reach full recovery within 12 months post-surgery.
Patello-Femoral joint replacement
This surgery is designed to relieve pain caused by localized damage to the patellofemoral joint—the area between your kneecap (patella) and the front of your thigh bone (femur). Osteoarthritis is the primary cause of this damage, where cartilage wears down, leading to the bones rubbing against bone during activities such as walking, squatting, or climbing stairs.
Patellofemoral knee replacement surgery involves replacing the damaged portion of your knee joint beneath the kneecap and the adjacent part of the thighbone with an artificial joint. This procedure aims to alleviate pain and restore function to the affected area.
DO YOU NEED SURGERY
Patellofemoral replacement is a suitable option if you experience severe pain due to localized damage confined to the underside of the kneecap. However, if you also have ligament damage, poor patellar tracking, inflammatory arthritis, or arthritis affecting other parts of your knee, you may need a different treatment approach. Riaz will help determine if and when surgery is appropriate based on your specific condition.
WHAT HAPPENS DURING SURGERY
A surgical incision is made at the front of the knee to access the damaged area. The damaged portion of the kneecap and the adjacent part of the thigh bone are removed. A plastic button is then fixed to the underside of your kneecap, and a new metal surface is attached to the front of the thigh bone. The skin incision is typically closed using medical adhesive (superglue)
WHAT COULD GO WRONG
Complications from this surgery are rare but can include infection, blood clots, delayed healing, pain, swelling, and stiffness, as well as risks associated with anaesthesia. There is also a potential need for additional surgery if arthritis develops in the areas that were not replaced, which might lead to the need for a total knee replacement in the future. In Riaz’s hands, over 90% of patellofemoral knee replacements last 9 years or longer (see figure 20). Discussing these risks and expressing any concerns with your surgeon is a crucial part of your pre-surgery consultations.
PARTICIPATING IN YOUR REHABILITATION
Preparation for your recovery starts before the surgery. Maintaining a healthy body weight is crucial, as being overweight increases stress on the knee and surgical risks. Aim to be at a healthy weight, stay active, and strengthen your knee muscles in the lead-up to surgery.
Your hospital stay will typically be 3-5 nights. Physiotherapy may begin on the day of or the day after your surgery. The goals of physiotherapy are to manage swelling, minimize pain, help you regain knee movement, assist with getting in and out of bed, walk using crutches, and climb stairs. Some knee pain and stiffness are normal during the initial months. Stay involved and positive during therapy, and diligently perform your home exercises for the best recovery outcomes.
BENEFITS YOU CAN EXPECT
In general, patients undergoing patellofemoral replacement tend to experience a quicker recovery period, reduced blood loss, less postoperative pain, improved physical function, and a greater range of motion compared to those undergoing total knee replacement. The typical expectation is that most patients will achieve significant pain reduction and reach full recovery within 12 months post-surgery.
DO YOU NEED SURGERY
Patellofemoral replacement is a suitable option if you experience severe pain due to localized damage confined to the underside of the kneecap. However, if you also have ligament damage, poor patellar tracking, inflammatory arthritis, or arthritis affecting other parts of your knee, you may need a different treatment approach. Riaz will help determine if and when surgery is appropriate based on your specific condition.
WHAT HAPPENS DURING SURGERY
A surgical incision is made at the front of the knee to access the damaged area. The damaged portion of the kneecap and the adjacent part of the thigh bone are removed. A plastic button is then fixed to the underside of your kneecap, and a new metal surface is attached to the front of the thigh bone. The skin incision is typically closed using medical adhesive (superglue)
WHAT COULD GO WRONG
Complications from this surgery are rare but can include infection, blood clots, delayed healing, pain, swelling, and stiffness, as well as risks associated with anaesthesia. There is also a potential need for additional surgery if arthritis develops in the areas that were not replaced, which might lead to the need for a total knee replacement in the future. In Riaz’s hands, over 90% of patellofemoral knee replacements last 9 years or longer (see figure 20). Discussing these risks and expressing any concerns with your surgeon is a crucial part of your pre-surgery consultations.
PARTICIPATING IN YOUR REHABILITATION
Preparation for your recovery starts before the surgery. Maintaining a healthy body weight is crucial, as being overweight increases stress on the knee and surgical risks. Aim to be at a healthy weight, stay active, and strengthen your knee muscles in the lead-up to surgery.
Your hospital stay will typically be 3-5 nights. Physiotherapy may begin on the day of or the day after your surgery. The goals of physiotherapy are to manage swelling, minimize pain, help you regain knee movement, assist with getting in and out of bed, walk using crutches, and climb stairs. Some knee pain and stiffness are normal during the initial months. Stay involved and positive during therapy, and diligently perform your home exercises for the best recovery outcomes.
BENEFITS YOU CAN EXPECT
In general, patients undergoing patellofemoral replacement tend to experience a quicker recovery period, reduced blood loss, less postoperative pain, improved physical function, and a greater range of motion compared to those undergoing total knee replacement. The typical expectation is that most patients will achieve significant pain reduction and reach full recovery within 12 months post-surgery.
Total Knee Replacement
This surgery is designed to relieve pain caused by the damaged surfaces of the knee joint grinding against each other. The most common causes of this damage are osteoarthritis and rheumatoid arthritis. Total knee replacement surgery involves replacing these damaged surfaces with a new artificial joint to alleviate pain and restore function.
DO YOU NEED SURGERY
Total knee replacement is recommended for individuals with severe arthritis who are experiencing disabling knee pain that has not improved with conservative treatments. Riaz will assess your condition and help determine if and when surgery is appropriate for you.
WHAT HAPPENS DURING SURGERY
A surgical incision is made at the front of your knee. The knee muscles are carefully split and moved aside to give your surgeon access to the joint. The damaged bone surfaces of your thighbone and shinbone are removed and replaced with artificial metal components. A plastic liner is placed between these metal parts. If the kneecap is also damaged, its worn surface is removed and resurfaced with a plastic button. The skin incision is typically closed with medical adhesive (superglue).
WHAT COULD GO WRONG
Potential complications from total knee replacement include deep infection, blood clots, delayed wound healing, injury to nerves or blood vessels, persistent knee pain and stiffness, and risks associated with anesthesia. While medications and exercises are prescribed to minimize these risks, some patients may still experience dissatisfaction with their new knee. In Riaz’s hands over 97% of total knee replacements last 6 years or longer (see figure 55 and 44). It is important to discuss these risks and any concerns with Riaz before proceeding with the surgery.
PARTICIPATING IN YOUR REHABILITATION
Preparation for your recovery starts before the surgery. Being overweight increases stress on the knee and surgical risk, so aim to achieve a healthy body weight, stay active, and strengthen your knee muscles in the lead-up to the surgery.
Physiotherapy may begin on the day of or the day after the surgery, with goals including managing swelling, minimizing pain, regaining knee movement, walking with crutches, and climbing stairs. Your hospital stay will likely be 3-5 nights. Some knee pain and stiffness are normal during the initial months. Stay engaged and positive during therapy, and consistently perform your home exercises for the best recovery outcomes.
BENEFITS YOU CAN EXPECT
91% of patients who walked without assistance before surgery are able to do so again within less than 3 months. Additionally, 91% of our patients with the current knee replacement experience either no pain or only mild pain (less than 3 out of 10) one year after the operation, and 86% report good knee function, as indicated by an Oxford Knee Score (OKS) greater than 34, and data on our patients from the AOANJR (see figure 55).
RECOVERY FROM TOTAL KNEE REPLACEMENT (PLEASE READ!)
Recovering from a total knee replacement is a lengthy process, typically taking up to a year to reach full recovery.
The first six weeks are often the most challenging, with noticeable pain, stiffness, and swelling. During this period, most people need crutches and strong pain relief. At around the six-week mark, you’re still ‘in the tunnel’, but you can see ‘light at the end of it’, and you’ve just about forgiven me!
The second six-week period brings further improvement. You’ll likely begin to walk without assistance and reduce or stop using strong painkillers.
By the three-month mark, most people start to feel significantly better and are about halfway through their recovery. Up until this point, your knee can feel worse than it did before surgery.
The remaining 50% of your recovery occurs gradually over the next nine months, with most reaching full recovery by about one year, occasionally extending to 18 months.
As your knee heals, pain, stiffness, and swelling will steadily decrease. These symptoms will be present throughout recovery but should show continuous improvement, which is generally a positive sign.
Finally, expect some sleep disruption in the first six weeks, but this usually improves as you recover.
DO YOU NEED SURGERY
Total knee replacement is recommended for individuals with severe arthritis who are experiencing disabling knee pain that has not improved with conservative treatments. Riaz will assess your condition and help determine if and when surgery is appropriate for you.
WHAT HAPPENS DURING SURGERY
A surgical incision is made at the front of your knee. The knee muscles are carefully split and moved aside to give your surgeon access to the joint. The damaged bone surfaces of your thighbone and shinbone are removed and replaced with artificial metal components. A plastic liner is placed between these metal parts. If the kneecap is also damaged, its worn surface is removed and resurfaced with a plastic button. The skin incision is typically closed with medical adhesive (superglue).
WHAT COULD GO WRONG
Potential complications from total knee replacement include deep infection, blood clots, delayed wound healing, injury to nerves or blood vessels, persistent knee pain and stiffness, and risks associated with anesthesia. While medications and exercises are prescribed to minimize these risks, some patients may still experience dissatisfaction with their new knee. In Riaz’s hands over 97% of total knee replacements last 6 years or longer (see figure 55 and 44). It is important to discuss these risks and any concerns with Riaz before proceeding with the surgery.
PARTICIPATING IN YOUR REHABILITATION
Preparation for your recovery starts before the surgery. Being overweight increases stress on the knee and surgical risk, so aim to achieve a healthy body weight, stay active, and strengthen your knee muscles in the lead-up to the surgery.
Physiotherapy may begin on the day of or the day after the surgery, with goals including managing swelling, minimizing pain, regaining knee movement, walking with crutches, and climbing stairs. Your hospital stay will likely be 3-5 nights. Some knee pain and stiffness are normal during the initial months. Stay engaged and positive during therapy, and consistently perform your home exercises for the best recovery outcomes.
BENEFITS YOU CAN EXPECT
91% of patients who walked without assistance before surgery are able to do so again within less than 3 months. Additionally, 91% of our patients with the current knee replacement experience either no pain or only mild pain (less than 3 out of 10) one year after the operation, and 86% report good knee function, as indicated by an Oxford Knee Score (OKS) greater than 34, and data on our patients from the AOANJR (see figure 55).
RECOVERY FROM TOTAL KNEE REPLACEMENT (PLEASE READ!)
Recovering from a total knee replacement is a lengthy process, typically taking up to a year to reach full recovery.
The first six weeks are often the most challenging, with noticeable pain, stiffness, and swelling. During this period, most people need crutches and strong pain relief. At around the six-week mark, you’re still ‘in the tunnel’, but you can see ‘light at the end of it’, and you’ve just about forgiven me!
The second six-week period brings further improvement. You’ll likely begin to walk without assistance and reduce or stop using strong painkillers.
By the three-month mark, most people start to feel significantly better and are about halfway through their recovery. Up until this point, your knee can feel worse than it did before surgery.
The remaining 50% of your recovery occurs gradually over the next nine months, with most reaching full recovery by about one year, occasionally extending to 18 months.
As your knee heals, pain, stiffness, and swelling will steadily decrease. These symptoms will be present throughout recovery but should show continuous improvement, which is generally a positive sign.
Finally, expect some sleep disruption in the first six weeks, but this usually improves as you recover.
Revision Knee Replacement
Revision knee replacement surgery is performed to address complications that have arisen after a previous knee replacement. These complications may include implant failure, infection, stiffness, loosening of the components, or persistent pain. This procedure is more complex than the initial knee replacement and requires meticulous planning and expertise to achieve the best results.
During the revision surgery, the original implants are removed, and new components are inserted to restore function and alleviate pain. The goal of revision knee replacement is to improve the patient’s quality of life by addressing the issues that led to the failure of the original implant.
