Knee Replacement Surgery (Knee Arthroplasty) Cost and Guide

Why have knee replacement surgery?

Knee joint replacement can improve a patient’s quality of life by reducing knee pain and increasing mobility. Patients can get back to doing their favourite activities and live with less pain.

Underlying causes for knee replacement include:

• Osteoarthritis
• Rheumatoid arthritis
• Traumatic arthritis
• Injury
• Joint deterioration due to age
• Joint deterioration caused by weight
• Genetic predisposition or family history of joint deterioration
• Gout
• Death of the knee bones

It’s a big decision to have knee surgery. This means patients may be good candidates for surgery if non-surgical methods are not managing their pain.

Non-surgical pain-management methods include:

• Painkillers and anti-inflammatory medication
• Steroid injections
• Weight loss
• Regular exercise
• Use of a mobility aid or walker

Goals of knee replacement surgery

What can a Knee Replacement achieve?

During a knee replacement, the surgeon will remove the damaged bone and cartilage from the knee joint. They will then replace them with new, artificial parts. A knee replacement often produces an improvement in a patient’s quality of life. After the surgery, patients should experience less pain and notice an improvement in mobility. As a result, they may also experience an improvement in their mental health. There are two main types of knee replacement available:

A Total Knee Replacement

A total knee replacement is the most common type of knee replacement. The surgeon will remove both the bottom of the thigh bone (femur) and the top of your shin bone (tibia) along with any cartilage that remains. In addition, they may have to replace the surface on the back of the kneecap. However, this is typically not necessary. Patients are more likely to experience medical complications after a total knee replacement. The incision will also be larger, and the hospital stay and recovery time will be longer. However, patients are also less likely to require further knee surgery after a total knee replacement. The surgeon will help you to decide which approach is the best option for the patient.

A Partial Knee Replacement

Another type of knee replacement is a partial knee replacement. This involves replacing only one side of the knee joint, either the inside (medial) or the outside (lateral). Therefore, if patients have a partial knee replacement, the surgeon will only remove part of the bottom of the thigh bone (femur) and part of the top of the shin bone (tibia) on one side of the knee joint.

The surgeon may choose to perform this method of a knee replacement if the knee has damage only to one side of it. The advantages of this approach are that the surgeon will make a smaller incision; therefore, there will be less scarring. Furthermore, the hospital stay will be shorter, and the recovery will be faster than a total knee replacement. On the other hand, patients are more likely to require further knee surgery with this technique.

How much does knee replacement surgery cost?

In the UK, the price of one total knee replacement with a private care provider begins at around £11,500 and can go up to £16,000. If patients only need a partial knee joint replacement, the price is slightly less, starting at £8,000 and going up to £15,000. The wide price range is based on a number of factors, including pre-existing health conditions and the hospital’s location.

After the consultation with the surgeon, patients will be given a customised price for their surgery.

Factors that may affect the price include the following:

• Costs related to your hospital stay
  • Accommodation
  • Nursing staff
  • Surgery theatre
  • Physiotherapy
  • Imaging costs
  • Medication
  • Pathology
• Aftercare
  • Medication prescribed by your surgeon
  • Mobility aid such as crutches or a cane
  • Post-operative physiotherapy sessions
  • Post-operative scans such as X-rays or MRIs
  • Post-operative appointments with your surgeon

The nature of all orthopaedic surgery is one size does not fit all. During the knee arthroplasty consultation, a treatment plan will be made and tailored to the individual patient.

Learn more about diagnostic packages.

Knee replacement surgery candidates

Knee replacement candidates often suffer from some form of arthritis. Most commonly, this is osteoarthritis but may also be rheumatoid or traumatic arthritis. Conditions such as gout and death of the knee bones may also require a knee replacement.

What is Osteoarthritis?

Osteoarthritis occurs as a result of years of wear and tear on the knee joint as patients age. A number of factors may affect the risk of developing this condition. These include:

• Age – the risk increases as one gets older. Most candidates are aged 60-80 but can be any age.
• Joint injury – overuse of the joint before it fully heals.
• Obesity – being heavier in weight puts more strain on the joints. (the knees and hips in particular).
• Family history – why this is the case is not fully understood yet.

The main symptoms of this condition are joint pain and stiffness. As a result, moving around becomes harder and simple daily tasks like walking become more difficult.

Some patients may only have mild symptoms and may try other types of treatments first. These treatments may include weight loss, regular exercise and the use of walking aids. In patients with moderate symptoms, using painkillers and anti-inflammatory medications may help. If these do not work, steroid injections into the knee joint may also be helpful.

Sometimes, however, none of these treatments significantly relieve symptoms. Therefore, surgical replacement of the knee may be the next best option. Patients may wish to speak to their GP or physiotherapist for advice.

Who are the Ideal Candidates for a Knee Replacement?

Nearly all candidates suffer from knee pain and stiffness. These may be due to a form of arthritis or another cause. If they are considering surgery as a treatment option, candidates are usually struggling with movement like bending and walking around. This can make life very difficult for them and can often have a negative impact on their mental health.

Below is a list of what an ideal candidate may be like. This is just a general guide, however. An orthopaedic surgeon will be able to tell patients if they are a good candidate or not.

Ideal knee replacement candidates:

• Have X-rays to show evidence of their condition.
• Are fit and well aside from their knee issues.
• Have no serious medical conditions.
• Have a healthy BMI.
• Are non-smokers or are prepared to quit for at least six weeks before and after the surgery.
• Have realistic expectations for the surgery.
• Have sufficient support from family and/or friends.
• Are willing to follow specific aftercare instructions, which will include physical therapy.

How is Knee Replacement Surgery Performed?

Knee joint replacement generally takes from one to two hours to perform. During surgery, damaged bone and cartilage are removed from the knee joint. The surgeon will then replace the damaged parts with an artificial joint, also called a prosthesis.

Types of Knee Replacement Incisions

The surgeon will make a vertical cut on the knee. The size of this incision depends on the type of replacement required. A total knee joint replacement involves a vertical incision down the entire front of the knee. Partial knee joint replacement usually requires a smaller vertical incision that is on the side of the knee joint that will be replaced.

Types of Knee Replacement Techniques

To replace the knee joint, the surgeon removes the damaged bone and cartilage from the knee after making the incision. They shape the bottom of the thigh bone called the femur, and the top of the shin bone called the tibia to fit the implant. This implant can replace the entire joint for a total knee replacement or only half of the joint for a partial knee replacement.

The surgeon will tell the patient what kind of knee joint replacement they will have in a consultation before the day of the surgery.

Total Knee Replacement

A total knee joint replacement involves implants on the femur and tibia and a cushioning plastic between the two.

The backside of the kneecap can sometimes also be resurfaced or be replaced with an implant.

Partial Knee Replacement

The procedure for partial knee joint replacement is nearly identical to that for total knee replacement. The only difference is that only half of the joint is replaced.

After placing the prosthesis, the surgeon will test the fit of the artificial joint by moving the leg. They may make some final adjustments at this point. When they are happy that the artificial knee joint fits nicely, they secure the prosthetics into place. Sometimes they do this with the aid of a medical-grade bone adhesive.

Once they are happy with the alignment, they will close the incisions, and the surgery will end. Patients will stay in the hospital to recuperate from surgery, usually for two to three nights.

Knee Replacement Surgery Potential Risks & Complications

Every surgery comes with possible risks and complications. To reduce the risk of complications forming, it is important that patients follow the exact recommendations given by their surgeon.

Some risks apply to surgeries of all kinds. These include, but are not limited to:

• Blood clot formation
• Anaesthetic complications
• Nausea and vomiting
• Post-operative pain

Risks and complications specifically associated with knee joint replacement surgery include:

• Fractures of the tibia or femur
• Loosening of the artificial joint
• Wearing out of the artificial joint
• Damage to arteries, nerves, or ligaments surrounding the knee
• Excessive bleeding
• Bruising
• Infection

Artificial joints are made to last for a long time. The materials used should be able to withstand the routines of active people. Most knee replacements last 10 to 15 years, however, there is research being done to see how we can make these artificial joints last even longer.

Total knee replacements tend to last longer than partial knee replacements. You are more likely to need another knee replacement if you are overweight or do regular heavy, manual work. It is important to have regular X-rays of your knee to review how your new joint is doing.

Your surgeon will advise you on how often you should have an X-ray – it may be every 5 years or so. If you have any complications like loosening or wearing away of your new knee joint, you may require revision surgery to fix this.

Yes, your physiotherapist will work with you while you are still in hospital to achieve this goal. This is particularly important if you live in a house with stairs. We want you to be able to leave hospital feeling confident that you can manoeuvre around your house safely.

While it is really important to be active after your knee replacement, you will need to build up your activities gradually. You will eventually be able to partake in light activities like jogging, cycling or dancing. However, high-impact activities like running, jumping and heavy lifting will not be possible for quite some time. Doing these sorts of activities against your surgeon’s advice may risk causing damage to your new knee joint.

Your physiotherapist will show you some exercises you can do to build up the muscle strength in your legs. It is important to follow this advice if you want to make a full recovery.

All of the information found on our website is sourced from highly reputable experts, government-approved authorities and is widely used by healthcare professionals.

• https://www.nhs.uk/conditions/knee-replacement/ NHS
• https://www.rcseng.ac.uk/ Royal College of Surgeons England