Total Knee Replacement

Over the last 15 years advances in surgical technique and joint design have meant that knee joint replacement has become a reliable and rewarding procedure, not only relieving pain and improving range of movement, but also improving the function of a diseased joint with great success.

Until relatively recently, arthritis of the knee joint caused many problems for surgeons. Historically knee surgery was regarded as a fairly risky undertaking with quite poor outcomes. This often resulted in failure and unfortunately gave knee surgery a poor reputation and standing with the general public.

However, radical redesign of the materials and the shape of joints inserted into the knee has improved beyond all recognition the results from this operation. Nowadays 95% of people undergoing knee joint replacement may expect good to excellent results if the operation is performed by a specialist knee surgeon.

The more recent designs of knee joint concentrate on replacing the worn bearing surface of the knee and keep all the other natural components of the joint such as the surrounding ligaments, soft tissues and knee cap intact. This allows minimal removal of the patient’s own tissues and just resurfaces the areas that are worn. As a result, the knee is felt to move more naturally and results of these more modern prostheses are much more satisfactory.

The prosthetic knee joint is a complex design made of a type of stainless steel which is tolerated by the body’s own natural tissues and shaped to resemble the real bearing surfaces of the knee. Highly resilient medical grade plastic fits into the gap between the two metal surfaces which cover the ends of the thigh and shin bones in the knee. This in many ways resembles the cartilage of the normal knee joint. The plastic is made of a specially designed high density polyethylene and allows the bearing surface of the femur to move upon it.

The type of knee joints I routinely employ is called the Nexgen Legacy Knee Replacement and it provides extremely reliable and safe results. It is produced by Zimmer, the largest Orthopaedic manufacturing company in the world, and scores the highest Patient Related Outcome Measures (PROM) in many national joint registries. Additionally, it has a long follow up and good track record in excess of 20 years.

Some patients have different shaped knees from the norm and I passionately believe the normal anatomy should be recreated. Specially shaped ‘female’ knees are available routinely as are custom made knees if required. Computer navigation is used if necessary. I was the first UK surgeon trusted by Zimmer to launch their female specific gender knee in this country which has been a great success.