This is a procedure to remove your damaged knee joint and replace it with an artificial joint.

A total knee replacement is carried out to treat knee pain, usually due to knee osteoarthritis, which is gradual wear and tear of the joint. During the procedure, both sides of the damaged joint are removed and replaced with an artificial joint (a prosthesis or implant). There are many different types of knee replacement and your surgeon will recommend the one that’s best for you.

Your consultant may recommend a knee replacement if:

• Your knee pain is so severe that you can’t sleep at night
• You have had trouble walking
• You’ve tried alternative treatments and they haven’t helped

You can be any age to have a knee replacement, but most people who have one are 60–80 years old.

As patients live longer and more active lives older knee implants may need replacing.

Reasons for revision of the knee can include:
• Infection
• Loosening of the implant
• Wearing of the implant surfaces
• Bone loss
• Incorrect alignment

Your consultant will do a complete examination and may order x-rays, blood tests or an MRI scan to full assess your current implant(s). If your knee implants have failed your surgeon may recommend revision surgery.

Revision of the knee is usually performed under general anaesthetic. The procedure can take 2 hours depending on the condition of your implants and any bone loss.

Your surgeon will make an incision (cut) down the centre of your knee. Your old implants will be carefully removed. Your surgeon will assess the bone surfaces to confirm if bone grafts might be needed. They will fit your new knee components and adjust any soft tissue, muscles and ligaments around the joint to confirm a good fit both when bending and straightening your leg.

Your soft tissues are sewn back together and the wound will be closed with stitches or staples.

Knee arthroscopy (also called keyhole knee surgery) allows your surgeon to see inside your knee joint using a camera inserted through small cuts in the skin.

• Knee arthroscopy is usually done under general anaesthetic
• The operation usually takes between half an hour and three-quarters of an hour
• Your surgeon will make 2 or 3 small incisions and insert a tiny camera to examine the inside of your knee
• They will wash out any loose material caused by wear of the joint surfaces
• It is usually possible for your surgeon to trim or repair a torn cartilage without needing to make a larger cut.

Hip arthroscopy is a procedure in which a miniature telescope is inserted through an incision over your hip joint commonly used to diagnose a problem, or occassionally to perform a treatment.

The anterior cruciate ligament is replaced with a piece of suitable tissue from elsewhere in the body.

The anterior cruciate ligament (ACL) is one of the important ligaments that stabilise your knee joint. If you have torn (ruptured) this ligament, the knee can collapse or ‘give way’ when making twisting or turning movements.

An ACL rupture happens as a result of a twisting injury to the knee. The common causes are football and skiing injuries. You can injure other parts of your knee at the same time, such as tearing a cartilage or damaging the joint surface.

ACL reconstruction is normally performed under general anaesthetic. The operation usually takes between an hour and an hour and a half. Your surgeon will make one or more cuts on the front and sides of your knee. Some surgeons perform the operation by arthroscopy (‘keyhole’ surgery) using a camera to see inside the knee. Your surgeon will replace the ACL with a piece of suitable tissue (a graft) from elsewhere in the body. The top and bottom ends of the replacement ligament are fixed with special screws or anchors into ‘tunnels’ drilled in the bone.