Private knee replacement surgery 

At HCA UK, you'll receive:

• Appointments confirmed within 24 hours
• Total knee replacement surgery at private hospitals across London and in Cheshire
• Expert care provided by specialist knee consultants

Total knee replacement surgery, also referred to as arthroplasty of the knee, is a common operation that's performed to help improve the joint's range of movement, increase stability and reduce pain levels. During this procedure, the surgeon clears your knee joint of any damaged bone and cartilage. All compartments of your knee joint are then replaced with artificial implants. 

The knee’s anatomy

In order to understand what happens during total knee replacement surgery, it’s important to understand the structure of your knee:

• Bones

The knee comprises three bones: the thigh bone (femur), shin bone (tibia) and kneecap (patella). 

• Ligaments

Ligaments are the bands of tissue that connect the thigh bone to the lower leg bones. These are called the lateral collateral and medial collateral ligaments. The medial collateral ligament (MCL) is on the inner side of your knee and this attaches the femur to the tibia. The lateral collateral ligament (LCL) runs on the outside of the knee and connects the femur to the fibula (positioned on the lateral side of the tibia). 

There are also the cruciate ligaments. These are inside the knee joint and they connect the tibia to the femur. The anterior cruciate ligament (ACL) runs diagonally in the middle of the knee and its role is to prevent the tibia from sliding in front of the femur. The posterior cruciate ligament (PCL) is at the back of the knee and also sits diagonally so that it crosses the ACL to form an X shape. The PCL keeps the shin bone from moving too far backwards. 

• Cartilage

Articular cartilage covers the end of the femur, providing a protective layer and helping the bones glide against one another. There’s also the lateral and medial menisci, which are two C-shaped structures that act as shock absorbers and also aid movement. 

However, if the cartilage wears away, the bones rub together and cause damage. This leads to pain and stiffness that affects the knee’s movement. An implant that’s added during total knee replacement surgery has smooth surfaces and replicates the bones of a healthy knee.

What happens during total knee replacement surgery?

Knee replacement surgery can be carried out under general anaesthetic or local anaesthetic. Your consultant and anaesthetist will discuss with you which will be most suitable.

Your surgeon will make a cut at the front of your knee and move the kneecap to the side. They’ll then remove any damaged bone (known as bone spurs, which are small bone growths) and cartilage in the joint. 

The two menisci are removed, along with the anterior cruciate ligament. The surgeon then removes cartilage and bone from the tibia and femur before applying an artificial joint implant – made of metal, ceramic or plastic – to the tibia and femur. If the kneecap is also degraded, a plastic replacement may be implanted during the procedure too. In many cases, we use robotic technology to increase accuracy when determining the exact size and positioning of the implant. 

Dissolvable stitches are then used to sew up the tissue around the knee and stitches or staples used to close the incision on the skin. Your surgeon will usually put in a small drain to remove any fluid for the first day after surgery. The whole procedure takes up to two hours.

When is a total knee replacement needed?

Several medical conditions cause knee pain. The most common is knee arthritis, which can be brought on by wear and tear (osteoarthritis), inflammatory disease (rheumatoid arthritis) or injury (post-traumatic arthritis). The risk of arthritis developing increases with age. However, gout is another type of arthritis that can cause knee pain and typically affects men over 30 and women after the menopause.  

Other conditions that can cause knee pain include:

• Haemophilia
• Bone dysplasia
• Knee deformities 
• Knee injuries

If the damage in the knee joint is contained to just one compartment, a partial knee replacement may be recommended. This is because it preserves more of the healthy bone and tissue than a total knee replacement.

How do I know if I need knee replacement surgery? 

To confirm that a total knee replacement operation will be the most effective way to treat your symptoms, your consultant will carry out a full medical assessment. This will include checks to see if alternative treatments have alleviated any symptoms. They'll also ask about any activities that make the pain worse. Your consultant will assess your knee's range of movement, strength and stability during a physical examination.

Imaging tests such as an X-ray and an MRI scan may be required to confirm the level of damage to the joint. A specialist musculoskeletal radiologist will report on the results, providing your consultant with the full picture before discussing treatment options with you.  

A total knee replacement surgery may be suggested if other treatments have not been successful and: 

• You’re experiencing severe pain, swelling and stiffness in your knee joint and your mobility is reduced
• Your knee joint pain is affecting your quality of life, including your sleep
• Routine tasks, such as shopping or going up or down stairs, are difficult or impossible 
• Your everyday life is affected. For instance, you cannot work or socialise.

Your consultant will also consider factors such as your age, general health and activity levels, along with any risk factors. If surgery is suggested, they'll discuss the potential risks and side effects with you so you can make an informed decision on the next steps.

Read our guide to knee pain to see whether you should make an appointment to discuss knee replacement surgery with one of our knee specialists. 

How do I prepare for knee surgery?

Your consultant will explain how total knee replacement surgery works and tell you what to expect on the day of your operation and the days that follow. You'll also be able to ask any questions you have about the procedure.

It's also beneficial to plan for your return home post-surgery. You’ll want to use this time to arrange for someone to pick you up from the hospital, as you won't be able to drive. It's worth seeing if someone can assist you with your day-to-day activities such as shopping while you recover too. 

What is the recovery from knee replacement surgery like?

How long you stay in hospital after total knee replacement surgery will depend on your health conditions, but the average stay is three days.

The incision made for your knee replacement will be covered post-surgery with a dressing. After leaving hospital, you’ll be advised on ways to reduce the risk of any infection. For example, avoid swimming and taking baths.

We know patients often like to know when they can drive again or return to work. Timelines are dependent upon how your implant incision heals. Your consultant will advise accordingly. 

Full recovery times vary between patients. This is due to the condition of your joint and surrounding ligaments, along with factors such as age and your fitness levels.