HOW COMMON IS KNEE/HIP REPLACEMENT?
These surgeries have been performed since the 1960s and are two of the most commonly performed orthopaedic procedures. Over 70,000 knee replacements are carried out every year in the UK. It is predicted to increase sevenfold by 2030.
HOW DO I KNOW IF I NEED A KNEE/HIP REPLACEMENT?
You may be advised knee/hip replacement if you suffer from severe pain in these joints which affect everyday activities such as walking, climbing stairs or getting out of chair, and if it keeps you awake at night. Surgery may be advised if you have tried other treatments, such as medications, which have not been successful in reducing pain and improving mobility.
IS IT SAFE TO HAVE A KNEE OR A HIP REPLACEMENT?
Knee and hip replacements are very successful, and are associated with very few complications. We have learnt from our past mistakes, and have changed many aspects of the surgery to make it safer and better for the patients.
Infection: The chance of a patient having infection in the early days and weeks after a joint replacement surgery is no more than 2 or 3%. Precautions are taken to reduce the chance of infection even further; these include having an extra-clean operating environment, modification of operating technique, antibiotic cover in the peri-operative period. Late infection is even more uncommon.
Clot in the leg (DVT) is also a concern, especially as a piece of it could break off and get lodged in the lungs (PE). Fortunately, the chance of a clot blocking a part of a lung is very rare and occurs in less than 1% of cases.
Nerve and artery damage is very rare indeed with either hip or knee replacement. The chance of it happening is well below 1%.
The chance of a hip dislocation (coming out of socket) is quoted at around 1%. However, with modern techniques and newer implants the chance of it happening has lessened even further. Knee dislocation is very rare.
On balance, both knee and hip replacements are very safe operations. Should a complication occur, it could have serious implications. We surgeons are very aware of the potential problems and try their best to minimise the chance of a complication.
These are only some of the complications involved with knee/hip replacement surgery.
HOW LONG WILL I BE IN THE HOSPITAL?
Patients normally stay in the hospital for 4-7 days after a knee or a hip replacement. The physiotherapists make sure that the patients are able to walk independently, with the help of crutches or walking frames, and negotiate stairs before being discharged from the hospital.
WILL I NEED PHYSIOTHERAPY AFTER KNEE OR HIP REPLACEMENT?
Physiotherapy is started the day after the operation and is continued until the patient is discharged home. Even after discharge, patients receive physiotherapy as per each individual’s requirement. It is usual for patients to receive physiotherapy for about six weeks.
IS BLOOD TRANSFUSION COMMON AFTER A JOINT REPLACEMENT?
The chance of receiving blood transfusion after a knee or a hip replacement is less than 50%. In a fit and healthy person with high pre-operative haemoglobin the chances of blood transfusion is low.
CAN A JEHOVAH’S WITNESS HAVE A JOINT REPLACEMENT?
Jehovah’s Witnesses are encouraged to have eat food rich in iron, or take iron supplements, before their operation in order to reduce their need for any blood replacement. There is a particular type of drain which can be inserted in the surgical wound, and the blood drained can then be returned to the patient’s circulation should it be needed. This is known to be acceptable to Jehovah’s Witnesses. This issue should be discussed with the surgeon in detail before the date of the surgery.
WILL I BE ABLE TO PLAY SPORTS AFTER KNEE LIGAMENT RECONSTRUCTION?
The ACL (anterior cruciate ligament) reconstruction is very successful, but it takes a long time for the patients to be fully active. Although the patient may be discharged from hospital on the day of, or the day after, surgery their activities are restricted. The restrictions are removed completely by nine months from the day of the operation.
Many elite sports persons who suffered damage to their ACLs, have successfully been able to return to their previous level of sports on full recovery from the operation. The same is true for personnel of the armed services.
HOW SOON CAN I DRIVE?
2-3 days following arthroscopy. 4-6 weeks after knee or hip replacement.