Knee replacement surgery is a safe and effective reconstructive procedure that may be suitable for patients with knee pain who have responded poorly to conservative treatments. 

If your knee is injured, whether that may be through trauma or arthritis, performing everyday activities such as walking, climbing stairs, and even lying down may cause some pain. If you have tried and exhausted all conservative treatment options such as medications, walking aids, and physical therapy, then you may consider knee replacement surgery. The information found below will help you understand the benefits of knee replacement surgery, and allow you to recognise its limitations.

When is knee replacement surgery recommended?

A knee replacement surgery may be recommended if the knee joint is worn, damaged, or stiff, and prevents you from carrying out your typical daily activity. If you have any of the following, then a knee replacement surgery may be of benefit to you:

  • Osteoarthritis with severe pain and stiffness
  • Deformity of the knee joint and instability
  • Chronic rheumatoid arthritis and pain
  • Previous traumatic knee injury
robotic knee replacement

Using state-of-the-art equipment we can comprehensively analyze your knee joint to provide the treatment tailored to you.

What are the types
of knee replacement
surgery?

The knee joint may be considered as having three compartments: (1) the medial (inner) compartment, (2) the lateral (outer) compartment and (3) the patellofemoral (between kneecap and femur) compartment. Depending on which compartments are affected by arthritis and are causing pain, knee replacement may be in the form of a total knee replacement or partial (unicompartmental) knee replacement. Different techniques and technologies may be used to perform both total and partial knee replacements. These include:

  • Robotic-assisted knee replacement
  • Computer-navigated (assisted) knee replacement
  • Patient specific instrumentation (PSI)

Total Knee Replacement

Total knee replacement involves replacing the main joint surfaces at the end of your thigh bone (femur) and shin bone (tibia). It may also involve resurfacing the kneecap (patella) with a plastic dome. The main steps of a knee replacement are:

  1. Damaged cartilage and bone are removed to prepare the joint for replacement.
  2. Once removed, the cartilage and damaged bone are replaced with a prosthetic. These parts are used to recreate the surface of the joint and are either cemented or fixed in place.
  3. If the patella is damaged, the undersurface will be replaced with a plastic dome.
  4. A spacer is then inserted between the new components to allow for smooth gliding.

Partial (Unicompartmental) Knee Replacement

A partial (unicompartmental) knee replacement may be recommended when osteoarthritis affects only one compartment of the knee joint. Partial knee replacement is a less invasive procedure compared to total knee replacement and so the rehabilitation and recovery is usually more rapid. Unicompartmental knee replacement is only suitable for those who have adequately strong knee ligaments with minimal deformity at the knee.

Robotic-assisted Knee Replacement

Robotic-assisted surgery is a new technique that aims to improve surgical precision, component alignment and balancing when performing the planned knee replacement surgery. The robotic system does not perform the procedure on its own per se, rather it aims to allow the surgeon to perform the surgery with increased accuracy. As an emerging technique aimed at improving patient outcomes, there are only early encouraging results in the medical literature. The Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) reported encouraging 2-year results showing that robotic-assisted partial knee replacement has an improved revision rate when compared to non-robotic-assisted partial knee replacement.

Computer Navigated Knee Replacement

Computer navigated (assisted) knee replacement works by using computers, infra-red cameras, and specialised light-reflecting tools to create images of the knee joint during surgery. This allows for computer assisted planning of the knee replacement.

What is patient specific instrumentation (PSI)?

Patient specific instrumentation is a technique sometimes used for total knee replacement that utilises pre-operative x-ray and MRI to plan a total knee replacement before manufacturing 3D models and patient specific instruments. The 3D model takes into account a patient’s unique size and deformity to plan the position of prosthesis.

What is a knee replacement made of and how is it fixed in place?

Total knee replacement prostheses are most commonly made of metal alloys, usually titanium or cobalt-chromium based. Some implants are made of ceramics or ceramic/metal mixtures. The spacer between the femoral and tibial component, and patella resurfacing component, is made of ultra-high molecular weight polyethylene. The components may be fixed to the femur and tibia with or without bone cement. Cement fixation, particularly on the tibial side of the joint, is known to have a reduced rate of revision.

How long will the total knee replacement last?

In 2019, the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) reported the overall revision rate of primary total knee replacement for osteoarthritis as 8.6% at 18 years after surgery.

Age is a major factor in determining how long a total knee replacement will last. Patients that are under the age of 55 have more than 3 times the rate of revision after 6 months and more than 6 times after 10 years, compared to patients aged over 75. Males have a higher rate of revision than females.

computer navigated knee replacement

Regular follow-ups with your physiotherapist are key in ensuring complete recovery and a more natural feel.

Recovery and Results

Whilst every patient has a different starting point prior to knee replacement, patients recover better when they are well informed and have undergone a period a physiotherapy with strength and conditioning prior to surgery. Patients are encouraged to walk almost immediately following surgery under the supervision of a physiotherapist. It takes approximately 2 weeks for the skin wound to be well healed and it may be wet after that.

Recovery after a total knee replacement is much longer when compared to total hip replacement. The range of motion of the knee joint before surgery largely determines the range of motion after total knee replacement. So, if you had a stiff knee before you are likely to have a stiff knee after knee replacement. Most knee replacement patients will have returned to driving a car by 6 weeks.

The primary goals of a total knee replacement are long term pain relief and the maintenance of independent mobility. There will be a steady improvement over the first 3 to 4 months. It is not unusual to still require some simple pain relief at this time. The knee replacement may remain swollen and warmer than the other side for up to 12 months after surgery. This is normal. The knee replacement is made of metal and plastic components and you may hear or feel them click from time to time. This can also be normal. If the clicking becomes painful, this however needs to be evaluated. Overall recovery for a total knee replacement can be up to 18 months.

Over 85% of patients have good pain relief after total knee replacement and are satisfied with the long-term result. A small percentage, approximately 5%, may have a vague discomfort in replaced knee that cannot be explained. Most patients are able to achieve improvements in mobility and quality of life, returning to activities such as golf, bowls, tennis, swimming and cycling. Total knee replacements are not intended for patients that engage in higher intensity activities such as contact sports, basketball and squash.

knee replacement

What are the main risks of knee replacement surgery?

Deep venous thrombosis (DVT). A blood clot may form in the leg after surgery. This has the potential to propagate or break off, travelling to lung. This is potentially life threatening. Medications can be used to reduce the risk of DVT. Other things that you can do to prevent clots include remaining well hydrated, wearing TED stockings and mechanical calf pumps immediately after the operation. Also, moving around and walking early after surgery will lower your risk of DVT.

Infection. Infection can be either superficial or deep down at the knee prosthesis. This may occur soon after surgery or even many years down the track. The knee replacement may need to be removed while being treated with antibiotics. Infection is the complication that orthopaedic surgeons fear the most. On average the risk of deep infection is 1%. This means that 1 in 100 patients may develop an infection. We do everything we can to prevent this. This includes antiseptic body wash before the operation, antibiotics during and after the operation, and meticulous wound care after the operation. All joint replacements are performed in a laminar air flow operating theatre under sterile conditions.

Fracture. The bone supporting the knee prosthesis may fracture both during or after surgery. Small fractures may heal on their own. Larger, unstable fractures may require further operations.

Loosening. The femoral or tibial component may become loose over time. This is rare with modern day techniques and prostheses. Further revision surgery may be required for this.

Knee replacement cost in Australia

The cost of total knee replacement in Australia varies widely, depending on whether treatment occurs in a public or private hospital, and the level of cover provided by private health insurance. Treatment at a public hospital is fully covered by Medicare. For treatment at a private hospital our staff will be able to provide you with a quotation, taking into account your level of health insurance coverage. If you do not have private health insurance but still wish to be treated in a private hospital, you will be provided a full fee estimate including fees for the surgeon, surgical assistant, anaesthetist, the private hospital and any required surgical implants or prostheses.

The Australian Medical Association (AMA) provides an annual list of medical services and the recommended fees for specialists. The fees are considered to be reasonable when taking into account the running costs of a medical practice and the level of training required. The Mid North Coast Hip & Knee Clinic uses the AMA recommended fee as a guide and aims to keep fees at an affordable level for patients.

knee replacement

Why choose us?

At the Mid North Coast Hip & Knee Clinic, we pride ourselves on providing patients with the highest standard of care in the treatment of all hip and knee disorders. We treat patients of all ages using a multi-disciplinary approach, working together to form a comprehensive and patient-specific treatment plan. We treat patients from all along the Mid North Coast and surrounding communities. This covers a large area from Yamba and Grafton in the north, to Coffs Harbour, Port Macquarie, Forster and Taree in the south.

Consulting rooms:

  • Coffs Harbour Specialist Centre
    230 Pacific Highway, Coffs Harbour New South Wales 2450
  • Mayo Private Hospital
    Potoroo Drive, Taree New South Wales 2430
  • Forster Private Hospital
    29-41 South Street, Forster New South Wales 2428

Hospital affiliations:

  • Coffs Harbour Health Campus
    345 Pacific Highway, Coffs Harbour New South Wales 2450
  • Baringa Private Hospital
    Mackays Road, Coffs Harbour New South Wales 2450
  • Macksville District Hospital
    Boundary Street, Macksville New South Wales 2447
  • North Shore Private Hospital
    3 Westbourne Street, St Leonards NSW 2065
  • Prince Of Wales Private Hospital
    Barker Street, Randwick New South Wales 2031
  • Mayo Private Hospital
    Potoroo Drive, Taree New South Wales 2430
  • Forster Private Hospital
    29-41 South Street, Forster New South Wales 2428

FAQs

If you had a few more questions, why not check out the section below:

If you’ve had previous knee surgery, it won’t stop you from having a knee replacement. However, the choice of prosthesis used by your surgeon may vary.

Here are several tips to help you ready your home for your recovery:

  • Clean and remove all clutter and tripping hazards
  • Install fall-prevention equipment
  • Prepare a rehabilitation and physio area
  • Sleep downstairs until you can walk upstairs comfortably

Total knee replacement is a surgical procedure that replaces the entire arthritic knee joint with an artificial joint (prosthesis). The main goals of total knee replacement are pain relief, improved mobility and quality of life. Common reasons for undergoing total knee replacement include:

  • Severe pain
  • Reduced mobility and independence
  • Difficulty performing job due to pain and stiffness
  • Inability to enjoy recreational activities due to pain and stiffness
  • Pain at night that interrupts sleep

658,596 total knee replacements have been performed in Australia since 1999. A total knee replacement replaces the end of the femur and the top of the tibia with femoral and tibial prostheses. The back of the kneecap (patella) is also commonly resurfaced. Between the femoral and tibial prostheses is a polyethylene (plastic) spacer.

Partial knee replacement is a surgical procedure that replaces only part of the knee joint with an artificial surface (prosthesis). 61,005 partial knee replacements have been performed in Australia since 1999. Partial knee replacements may be suitable for patients with arthritis limited to only one compartment of the knee joint. This is most commonly the medial or lateral compartment of the knee joint. The procedure preserves the remaining healthy compartments and ligaments of the knee joint. When compared to total knee replacement, partial knee replacement involves a smaller incision and approach, less pain after surgery, a more natural feeling knee joint and faster rehabilitation.

Patient specific instrumentation is a technique sometimes used for total knee replacement that utilises pre-operative x-ray and MRI to plan a total knee replacement before manufacturing 3D models and patient specific instruments. The 3D model takes into account a patient’s unique size and deformity to plan the position of prosthesis.

Computer-assisted surgery works by collecting information about the unique shape and motion of the knee joint during surgery. The total knee replacement is then virtually planned with computer assistance. The position of the prosthesis is planned by taking into account the unique size, alignment, balance and motion of the knee during surgery. In some studies, computer-assisted surgery has been shown to produce improved prosthesis survivorship and lower revision rates in younger patients.

Robotic-assisted surgery is a new technique that aims to improve surgical precision, component alignment and balancing when performing the planned knee replacement surgery. The robotic system does not perform the procedure on its own per se, rather it aims to allow the surgeon to perform the surgery with increased accuracy. As an emerging technique aimed at improving patient outcomes, there are only early encouraging results in the medical literature. The Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) reported encouraging 2-year results showing that robotic-assisted partial knee replacement has an improved revision rate when compared to non-robotic-assisted partial knee replacement.

Total knee replacement prostheses are most commonly made of metal alloys, usually titanium or cobalt-chromium based. Some implants are made of ceramics or ceramic/metal mixtures. The spacer between the femoral and tibial component, and patella resurfacing component, is made of ultra-high molecular weight polyethylene. The components may be fixed to the femur and tibia with or without bone cement. Cement fixation, particularly on the tibial side of the joint, is known to have a reduced rate of revision.

In 2019, the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) reported the overall revision rate of primary total knee replacement for osteoarthritis as 8.6% at 18 years after surgery. Age is a major factor in determining how long a total knee replacement will last. Patients that are under the age of 55 have more than 3 times the rate of revision after 6 months and more than 6 times after 10 years, compared to patients aged over 75. Males have a higher rate of revision than females.

Whilst every patient has a different starting point prior to knee replacement, patients recover better when they are well informed and have undergone a period a physiotherapy with strength and conditioning prior to surgery. Patients are encouraged to walk almost immediately following surgery under the supervision of a physiotherapist. It takes approximately 2 weeks for the skin wound to be well healed and it may be wet after that.

Recovery after a total knee replacement is much longer when compared to total hip replacement. The range of motion of the knee joint before surgery largely determines the range of motion after total knee replacement. So, if you had a stiff knee before you are likely to have a stiff knee after knee replacement. Most knee replacement patients will have returned to driving a car by 6 weeks.

The primary goals of a total knee replacement are long term pain relief and the maintenance of independent mobility. There will be a steady improvement over the first 3 to 4 months. It is not unusual to still require some simple pain relief at this time. The knee replacement may remain swollen and warmer than the other side for up to 12 months after surgery. This is normal. The knee replacement is made of metal and plastic components and you may hear or feel them click from time to time. This can also be normal. If the clicking becomes painful, this however needs to be evaluated. Overall recovery for a total knee replacement can be up to 18 months.

Over 85% of patients have good pain relief after total knee replacement and are satisfied with the long-term result. A small percentage, approximately 5%, may have a vague discomfort in replaced knee that cannot be explained. Most patients are able to achieve improvements in mobility and quality of life, returning to activities such as golf, bowls, tennis, swimming and cycling. Total knee replacements are not intended for patients that engage in higher intensity activities such as contact sports, basketball and squash.

Deep venous thrombosis (DVT). A blood clot may form in the leg after surgery. This has the potential to propagate or break off, travelling to lung. This is potentially life threatening. Medications can be used to reduce the risk of DVT. Other things that you can do to prevent clots include remaining well hydrated, wearing TED stockings and mechanical calf pumps immediately after the operation. Also, moving around and walking early after surgery will lower your risk of DVT.

Infection. Infection can be either superficial or deep down at the knee prosthesis. This may occur soon after surgery or even many years down the track. The knee replacement may need to be removed while being treated with antibiotics. Infection is the complication that orthopaedic surgeons fear the most. On average the risk of deep infection is 1%. This means that 1 in 100 patients may develop an infection. We do everything we can to prevent this. This includes antiseptic body wash before the operation, antibiotics during and after the operation, and meticulous wound care after the operation. All joint replacements are performed in a laminar air flow operating theatre under sterile conditions.

Fracture. The bone supporting the knee prosthesis may fracture both during or after surgery. Small fractures may heal on their own. Larger, unstable fractures may require further operations.

Loosening. The femoral or tibial component may become loose over time. This is rare with modern day techniques and prostheses. Further revision surgery may be required for this.

If you suffer from a knee or hip condition,
we can help you get back to life.

Pain and discomfort caused by orthopaedic conditions affect our patients negatively every day.
Which is why we work so hard to provide relief for every one of our patients. Our team is highly
trained in the diagnosis, treatment and management of all musculoskeletal conditions and injuries.

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