How long does a knee prosthesis last

Age is of particular importance, because a person with a life expectancy of 15 years has a much better chance of avoiding a future operation than a person with a life expectancy of 30 years.

In addition, younger patients tend to be more active and put more stress on their new joint. For these reasons, some surgeons advise younger patients to put off surgery as long as possible, even if that means suffering with pain, stiffness, and reduced mobility.

As published in the April edition of the medical journal The Lancet , researchers found that:. Some orthopedic surgeons might scoff at these findings and say, "My patients do better than those in in this study.

On the other hand, having this information is valuable. Research shows that people who have partial knee replacements are more likely to have the knee revised than people who have a total knee replacement — about 1 person in 10 needs further surgery after 10 years.

Even though the operation involves less interference with the knee it is often a more complex operation than total knee replacement. Your surgeon may therefore prefer to offer you a more predictable total knee replacement. Partial knee replacement can be considered at any age. For younger people, it offers the opportunity to preserve more bone, which is helpful if you need revision surgery at a later stage. For older people, partial knee replacement is a less stressful operation with less pain and less risk of bleeding.

The outcome of the surgery, however, depends on the type of arthritis, rather than your age. A kneecap replacement involves replacing just the under-surface of the kneecap and its groove the trochlea if these are the only parts affected by arthritis. It's possible to replace just the under-surface of the kneecap and its groove the trochlea if these are the only parts affected by arthritis.

This is also called a patellofemoral replacement or patellofemoral joint arthroplasty. The operation has a higher rate of failure than total knee replacement — which may be caused by the arthritis progressing to other parts of your knee.

Some surgeons advise a total knee replacement as the results are more predictable. The operation is only suitable for about 1 in 40 people with osteoarthritis. More research is needed to understand which people are likely to do well with this operation. A complex knee replacement may be needed if you're having a second or third joint replacement in the same knee, or if your arthritis is very severe. These knee replacements usually have a longer stem, which allows the component to be more securely fixed into the bone cavity.

The components may also interlock in the centre of the knee to form a hinge to give greater stability. Research has shown that four out of five people who've had knee replacement surgery are happy with their new knees.

For those people who aren't happy, the main cause for dissatisfaction is continuing pain which may not be due to a problem with the operation. This is more of a risk if you have relatively minor joint damage which may still cause severe symptoms before surgery. If your joint damage isn't very severe it may be better to carry on with non-surgical treatments rather than risk a poor outcome from surgery.

Possible disadvantages of knee replacement surgery can include replacement joints wearing out over time, difficulties with some movements and numbness. We now know that knee replacements aren't so likely to be effective in the early stages of arthritis. We can be much more confident of a good outcome where the arthritis is more advanced. Most knee replacements will last for 20 years or more, so younger patients are more likely to need a repeat knee operation at some point in later life.

The chances of needing repeat surgery are increased if:. Although your knee can be replaced again if necessary, revision surgery is more complicated and the benefits tend to lessen with each revision. Most doctors recommend non-surgical conservative treatments before considering a knee replacement. These include:. Keyhole surgery techniques arthroscopy to smooth damaged cartilage and remove debris from the knee joint can only be used in very specific circumstances.

If there are mechanical symptoms such as 'locking' of the knee then removing loose fragments of bone and cartilage may avoid having to have a knee replacement at that stage. There's no evidence that it's of benefit for arthritis generally.

This operation, which is performed by keyhole surgery, involves making holes in exposed bone surfaces with a drill or pick. This encourages new cartilage to grow from the bone marrow.

This is an operation which may help younger patients. It involves cutting the shin bone crosswise, creating a wedge to shift the load away from the area affected by arthritis. Osteotomy may be considered as a way of putting off a knee replacement operation.

However, it can make it more difficult to carry out a successful total knee replacement later on — especially if during the osteotomy the surgeon has to cut through the medial collateral ligament at the inner surface of the knee.

Rarely, if the outer part of the knee is affected by arthritis, this operation is performed on the end of the thigh bone to shift load inwards.

If only the hard cartilage is damaged, new cartilage can be grown in a test tube from your own cells. The new cartilage is then applied to the damaged area. This technique is mainly designed to repair small areas of cartilage damage resulting from accidental injury to the knee joint. It's usually therefore only done as part of a research trial, as are newer techniques using stem cells. We explain which foods are most likely to help and how to lose weight if you need to.

In England, our NHS right to treatment within 18 weeks is at risk. Visit our campaign page to learn more. It's a good idea to make sure your general health is as good as it can be before your operation, for example if you have other health problems such as diabetes or high blood pressure.

Your orthopaedic surgeon will probably suggest exercises to strengthen the muscles at the front of your thigh quadriceps , which often become weak with arthritis. The stronger these muscles are before surgery, the quicker your recovery is likely to be.

Exercises that involve raising your foot against gravity are best. You'll probably be invited to a pre-admission clinic a few weeks before surgery.

This may include the following tests:. You should also discuss with your surgeon, anaesthetist or nurse whether you should stop taking any of your medications or make any changes to the dosage or timings before you have your surgery. Different units may have different views. Start planning for your return home and recovery arrangements. It's important to ask any questions you may still have at this stage. Your knee will then be marked for the operation.

You'll be asked if you're willing for details of your operation to be entered into the National Joint Registry NJR database.

The NJR collects data on hip and knee replacements in order to monitor the performance of joint implants. It is only by measuring the outcomes of all knee replacements that we can learn what works best and for which patients.

If you're taking drugs that affect blood clotting, such as warfarin and clopidogrel, you should follow instructions to prevent too much bleeding during and after surgery.

You'll probably be given a sedative medication a pre-med while waiting in the admission ward. Most knee replacements are now done under either a spinal or an epidural anaesthetic. These numb the body from the waist down, but you'll remain awake throughout the operation. If you have a general anaesthetic instead, you may also be given a nerve block — this will block pain in your leg for up to 36 hours after surgery but will also weaken the leg temporarily.

Many surgeons instead inject a type of local anaesthetic into the tissues around the knee during the operation to numb the pain but still allow the muscles to work so you can get up sooner after the operation. The operation itself may take from as little as 45 minutes to over two hours, depending on how complex the surgery is. Most people can leave hospital between one and four days after having knee replacement surgery.

You'll need to make arrangements for wound care and you'll usually have follow-up appointments from six weeks after your operation. This may include:. There's often no need to have a blood transfusion because your body can replace any blood lost during or after surgery. If the operation is more extensive you may need blood from a donor. An alternative is to recycle the blood which drains from your knee — returning it into your body through a tube in a vein auto-transfusion.

After the first day or so, the tubes giving you painkillers, fluids or oxygen therapy will be removed. You may have a tube catheter inserted for a few days to drain urine from your bladder, especially if both knees have been replaced at the same time.

Most people are able to start moving about soon after surgery, which is good for lung function and the circulation. The hospital team encourage most people to follow the enhanced recovery programme ERP. This aims to get you walking and moving within 12—18 hours and home within four days. The programme focuses on making sure that you take an active role in your own recovery process. Nursing staff and physiotherapists will help you to start walking. If you've had minimally invasive surgery or are on the ERP, this may be on the same day as your operation.

This is designed to support your knee until your muscles are working effectively. Your physiotherapist will be able to advise you on getting about and will explain the exercises you need to do to keep improving your mobility.

Versus Arthritis have recently awarded a grant to the TRIO study, which will look at the effect of targeting specific physiotherapy at patients who are having problems six weeks after having a knee replacement. The aim of the study is to see whether early treatment gives a better outcome one year after the operation.

Before you leave hospital an occupational therapist or physiotherapist will explain the best ways to get dressed, take a shower and move about, and they'll assess what equipment you might need to help you. You should also make arrangements for wound care.

Further follow-up appointments are also usually recommended. Usually you can return to work when you feel comfortable that you can continue with your normal role. If you sit down most of the day at work, this may be in six to eight weeks, but if your job involves standing for long periods of time or manual work you may need 10—12 weeks.

These include the patient's condition, age, body weight, and the surgical implant. Younger patients often ask how long does a total knee replacement last and will need the implant to last longer than older patients. As a result, patients who have a total knee replacement may need to have a revision done to replace their implant at some point in their lifetime. To maximize how long a total knee replacement lasts, patients should avoid high impact activities, competitive sports, running, high impact aerobics, and heavy manual labor.

Patients who are overweight place a significant amount of impact on their bodies. Maintaining a healthy weight lowers the amount of stress placed on the new total knee joint. Avoiding complications will also improve how long a total knee replacement lasts.

After the surgery, it is important to follow all orthopedic surgeon instructions and follow up with physical therapy. This will decrease the risk of complications such as infection or limited movement of the knee. Complications can limit how long the knee replacement lasts.