Total Knee Replacement

Total Knee Replacement

Total knee replacement surgery is a commonly performed procedure used to treat advanced knee arthritis and ongoing knee pain that is affecting mobility, function, and day-to-day activities.

For many people, knee arthritis can gradually make walking, exercise, stairs, work, or even simple daily movements increasingly difficult. When symptoms are no longer improving with non-surgical treatment, knee replacement surgery may be considered.

Dr Alex Nicholls is an orthopaedic surgeon with experience in adult knee surgery and knee replacement procedures, with a focus on evidence-based treatment and individualised patient care.

What Is Knee Arthritis?

Knee arthritis occurs when the smooth cartilage within the knee joint gradually wears down over time.

As the cartilage deteriorates, the joint surfaces become less smooth, which can lead to:

• Pain

• Stiffness

• Swelling

• Reduced movement

• Difficulty with activity

The most common form is osteoarthritis, although arthritis may also develop following:

• Previous injury

• Meniscal damage

• Ligament injury

• Inflammatory conditions

Common Symptoms of Knee Arthritis

Symptoms of knee arthritis often develop gradually and may include:

• Pain during walking or activity

• Stiffness, particularly in the morning

• Swelling around the knee

• Reduced range of motion

• Difficulty with stairs or uneven ground

• Pain after prolonged sitting

• Reduced walking tolerance

Some people may also notice clicking, grinding, or changes in alignment of the knee.

When Is Total Knee Replacement Considered?

Total knee replacement surgery is generally considered when:

• Knee pain is significantly affecting quality of life

• Daily activities become difficult

• Mobility is increasingly limited

• Non-surgical treatment is no longer providing sufficient relief

Not every patient with arthritis requires surgery.

Initial treatment options may include:

• Physiotherapy

• Activity modification

• Strengthening programs

• Anti-inflammatory medication

• Injection therapy

• Weight management strategies

Surgery is considered when symptoms remain persistent despite appropriate non-surgical management.

What Happens During Total Knee Replacement Surgery?

During total knee replacement surgery, damaged joint surfaces are removed and replaced with prosthetic components designed to restore movement and improve joint function.

The procedure aims to:

• Improve pain related to arthritis

• Restore movement

• Improve walking tolerance

• Improve day-to-day function

Surgical planning is tailored to the individual patient’s anatomy, symptoms, and functional goals.

Technology in Knee Replacement Surgery

Technology continues to play an increasing role in modern knee replacement surgery.

Advances in:

• Surgical planning

• Computer navigation

• Alignment assessment

• Implant positioning

aim to improve precision and consistency during surgery.

Dr Alex Nicholls has contributed to research examining technology usage and revision rates in total knee arthroplasty (TKA).

Recovery After Total Knee Replacement

Recovery after knee replacement surgery is gradual and varies between individuals.

Early Recovery

The initial phase focuses on:

• Pain management

• Swelling control

• Walking

• Restoring knee movement

Many patients begin mobilising soon after surgery with support from physiotherapists.

Ongoing Recovery

As recovery progresses, rehabilitation focuses on:

• Strength rebuilding

• Walking mechanics

• Improving flexibility

• Returning to daily activities

Recovery timelines vary depending on:

• Pre-operative function

• General health

• Strength

• Rehabilitation progress

Rehabilitation After Knee Replacement Surgery

Physiotherapy and rehabilitation are important parts of recovery following knee replacement surgery.

Rehabilitation may include:

• Range of motion exercises

• Strengthening exercises

• Walking progression

• Balance work

• Functional movement training

The goal is to gradually improve movement, confidence, and day-to-day function.

Returning to Activity

Most patients gradually return to:

• Walking

• Daily activities

• Low-impact exercise

The timeline for recovery differs between individuals and depends on overall progress during rehabilitation.

Frequently Asked Questions

Knee replacement surgery may be considered when arthritis symptoms are significantly affecting quality of life and non-surgical treatment is no longer providing sufficient relief.

Is knee replacement surgery only for older patients?

Not necessarily. Treatment decisions are based on symptoms, joint damage, function, and overall health rather than age alone.

How long does recovery take after total knee replacement?

Recovery varies between individuals. Most patients gradually improve over several months as strength and movement continue to recover.

Will I need physiotherapy after surgery?

Physiotherapy is commonly recommended following knee replacement surgery to assist with strength, movement, and walking recovery.

Can both knees be replaced?

This depends on the individual patient and the severity of arthritis. Treatment planning is discussed on a case-by-case basis.

Are there alternatives to surgery?

Yes. Non-surgical treatment options such as physiotherapy, strengthening programs, injections, and activity modification are often considered before surgery.

Evidence-Based Knee Care

Dr Alex Nicholls maintains an active involvement in orthopaedic research and education, including research relating to knee arthroplasty and surgical technology.

Treatment decisions are based on individual symptoms, clinical assessment, imaging findings, and functional goals.