Knee replacement surgery is a significant medical procedure that can greatly improve the quality of life for individuals suffering from severe knee pain and mobility issues.
However, deciding whether (or not) to undergo this surgery is a complex decision that requires careful consideration of various factors. David Stitson, a renowned Orthopaedic Surgeon in Plymouth, outlines five critical factors that should be considered when deciding on knee replacement surgery, along with his expert recommendations for recovery.
1. Severity of Knee Pain and Functionality
One of the primary factors to consider is the level of pain and how it impacts daily activities. According to Mr Stitson, patients should assess whether the pain is manageable with conservative treatments like medication, physio or lifestyle modifications. If knee pain persists despite these efforts and severely limits mobility and daily function, it may be time to consider surgery. The ability to perform basic tasks such as walking, climbing stairs, and even getting in and out of a chair without significant discomfort is a crucial indicator.
Recommendation:
Before opting for surgery, patients should attempt a comprehensive rehabilitation program. If pain and disability remain unmanageable, knee replacement surgery may be the best option to restore function and quality of life.
2. Degree of Joint Damage
The extent of damage to the knee joint is another critical factor in deciding whether to proceed with knee replacement surgery. Mr Stitson emphasises that this can be evaluated through imaging. The most useful test is an x-ray, although sometimes MRI scans are helpful in revealing the condition of the bones and cartilage. Severe osteoarthritis, rheumatoid arthritis or post-traumatic arthritis are common conditions that lead to joint deterioration and may lead to the need for surgery.
Recommendation:
If imaging shows advanced joint damage, especially if the cartilage is fully worn away and bones are rubbing together, surgery may be the most effective way to alleviate pain and prevent further deterioration.
3. Patient’s Age and Activity Level
Age and activity level play a significant role in the decision-making process. While knee replacement surgery is most common in patients over 60, Mr Stitson notes that younger, active patients might also benefit from the procedure if they suffer from debilitating knee conditions. However, the durability of the prosthesis must be considered, as younger patients may outlive the lifespan of their artificial knee, potentially requiring knee replacement revision surgery in the future.
Recommendation:
Patients should consider their current and future activity levels. For older patients or those with a more sedentary lifestyle, knee replacement can greatly enhance mobility and reduce pain. Younger, more active individuals should discuss long-term outcomes with Mr Stitson to weigh the benefits and risks carefully.
4. Overall Health and Medical Conditions
A patient’s overall health and any pre-existing medical conditions are crucial in determining their suitability for orthopaedic surgery. Conditions such as obesity, diabetes, or heart disease can increase the risks associated with surgery and affect recovery. Mr Stitson advises that patients work closely with their healthcare providers to optimise their health before undergoing knee replacement surgery.
Recommendation:
Patients should aim to improve their general health before surgery. This could involve losing weight, managing chronic conditions like diabetes, and quitting smoking. A healthier body can lead to a smoother surgery and a quicker recovery, with reduced risk of complications.
5. Patient Expectations and Mental Preparedness
The expectations and mental preparedness of the patient are often overlooked but are vital for a successful outcome. Mr Stitson points out that “patients need to have realistic expectations regarding the results of the surgery and the recovery process.” While knee replacement can significantly reduce pain and improve mobility, it may not restore the knee to its original state or allow for high-impact activities.
Recommendation:
Patients should have a clear and realistic understanding of the surgery’s benefits and limitations. Stitson recommends mental and emotional preparation, possibly including counselling or support groups, to ensure patients are psychologically ready for the surgery and the recovery journey.
It is essential to discuss all your options with Mr Stitson, who can guide you through the treatment process and advise on how you can achieve the best possible outcome.
Knee Surgery Recovery Recommendations from David Stitson
Recovery from Total Knee Replacement Surgery is a critical phase that requires careful management to achieve the best outcomes.
Here are David Stitson’s top recommendations for a successful recovery:
- Follow a Structured Rehabilitation Program:
Engaging in a physiotherapy program tailored to your specific needs is essential. This helps to regain strength, improve mobility and reduce the risk of complications. - Pain Management:
Effective pain management is crucial during the recovery period. Mr Stitson advises patients to follow their prescribed pain medication regimen and use ice therapy and elevation to reduce swelling. - Adopt a Healthy Lifestyle:
Maintaining a healthy weight, staying active within the limits recommended by Mr Stitson and eating a balanced diet rich in nutrients can significantly enhance recovery. - Attend Follow-Up Appointments:
Regular check-ups with Mr Stitson are important to monitor the healing process and address any issues that may arise. The first follow-up appointment is usually at 6 weeks post-op. - Be Patient:
Recovery from knee replacement surgery takes time. Mr Stitson reminds patients that while most people see significant improvements within a few months, it may take up to a year to fully realise the benefits of the surgery.
Thorough evaluation
Whether to undergo knee replacement surgery is a major decision that requires a thorough evaluation of various factors, including the severity of pain, loss of function, joint damage, patient age, overall health and mental preparedness. Mr Stitson’s expert advice underscores the importance of a personalised approach, ensuring that each patient makes an informed decision and follows a structured recovery plan for the best possible outcomes.
About Knee Surgery
Knee replacement surgery replaces the worn out, painful and stiff knee joint with a new prosthetic joint. This procedure which may be a partial or a total replacement is normally performed under spinal anaesthesia and is usually followed by a night or two in the hospital. Day-case knee replacement surgery may be an appropriate option for you.
About Mr Stitson
David Stitson is a Plymouth-based Consultant Trauma and Orthopaedic Surgeon. Trained both in the UK and internationally, he has worked in medicine for more than 20 years for the NHS, for the Royal Air Force and in private practice. Mr Stitson operates privately at the Nuffield Health Hospital, Plymouth.
The Nuffield Plymouth CQC Rating
The Nuffield Hospital has a history that spans over half a century and has built a reputation for high standards of care, professionalism and expertise in delivering health services. They aim for continuous quality improvement in everything they do.
Active Quality and Governance programmes are in place at the Nuffield Hospital Plymouth. As part of this, the hospital is inspected by independent healthcare regulators to ensure it meets the fundamental standards of quality and safety as determined by the regulating body (CQC).
In the most recent inspection, Plymouth Nuffield Hospital was rated as ‘Good’ overall, however, the surgical element of the inspection was rated as ‘Outstanding’. The hospital was referred to as:
“Outstanding in effective and caring, and
Good in safe, responsive and well-led.”
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