Partial knee replacement

[BonnieMagic]

Hi, after waiting just over two years I’m scheduled to have a partial knee replacement in March. Does anyone have any advice as to what to expect please? I don’t know anyone who has had a partial just loads of total knee replacements. My letter states a maximum of one night in hospital which sounds a frighteningly short stay - it’s a private hospital on the NHS. I’ve had a total hip replacement so I know that exercises are key to a good recovery but any advice/reassurance would be much appreciated.

[Hidden]

Hi BonnieMagic,

I had a right knee, partial knee replacement in November 2015 (medial compartment). I was done as an NHS patient in a private hospital. The surgeon was both private and NHS. No sweat. I was admitted on a Friday morning and sent home midday on the Monday morning. At the time I was 71 and the surgeon felt his work was good for 15 years.

I am on Warfarin and had to stop this 6 days before surgery. After surgery when back in my room I was given two injections of a bridging anticoagulant, Fragmin. A few hours later I went back on my evening dose of Warfarin and other night time medications ( for Atrial Fibrillation).

As soon as I was conscious I was started on the first of many exercises, very gentle at first but rapidly cranking up several notches. Exercises and Pain go hand in hand. They tried me on liquid morphine to help pain control. Didn't work. I ended up resorting to the pain relief I'd been prescribed in the early days when my knee problem was first diagnosed. ... CoCodomol 30/500 ... a prescription only medication. This stuff was the best I could take given I was on Warfarin.

Before being sent home I was introduced to a whole range of exercises to be undertaken at home and given a booklet on what to do and how to do it. However, I soon discovered a whole range of short videos on YouTube relating to exercises that need to be undertaken during the recovery stages and after dressings had been removed and I was cleared of any infection in, along and around the incision line.

Several things to now stress ... AND STRESS .... make sure you have the best possible pain relief for when you get home ... you'll need it. (unless you are immune to high grade pain). The point is unless you have the best pain relief your ability to successfully exercise your operated knee will be severely impaired. This in turn will impact on your recovery, how quickly you recover, how well you recover and most importantly how normal you will walk moving forward.

You need an exercise discipline and must be prepared to devote 3 to 5 exercise sessions per day. I also went to a sports injury massage therapist after dressings were removed and the incision area cleared of infection. She massaged along the incision line and all around it using Aloe Vera Gel .... the object of this, and indeed all exercises is to prevent scar tissue forming within the incision area - inside the operated knee. This is vital. Once scar tissue gets a grip exercises will become more and more difficult and will work against a successful recovery and normal walking in the future.

As a guide to my timeline .......... 1) dressings removed and infection all clear given at 21 days. 2) able to drive my car again at 8 weeks and return to driving my work vehicle, a bus, at 11 weeks. Could all these time lines be shorter ... yes, but only by about 2 weeks. That's because Christmas 2015 intervened and my surgeon had two weeks holiday.

Hope this is something close to what you are looking for. TBH its not a walk in the park, but without it you'll never be pain free and never have any QOL in the future if you don't do it. The hardest thing for me even now is kneeling ........... the cat always manages to get her toy mouse under the sofa which means I have to get down, kneel on the knee, and load the knee with pressure while I get flat to retrieve the bloody toy !

Please feel free to contact me with any questions ... but do look at the videos. A video is worth a thousand words. Get onto youTube, and in the search box type in ....... partial knee replacement exercises.

Oh yes, make sure that you organise your home for quite a while you will be hobbling around on crutches ............ so I found it very hard to open a can of beer whilst propped up on crutches. 😂😂 I would imagine that some time before surgery you'll be called in to have a briefing on what is ahead and you'll then order your bathroom furniture, raised toilet seat, shower stool, also crutches ....... whatever. Food and groceries can be ordered on line .......... sit back and think kitchen and food now and imagine doing everything you do now, on crutches. Include in that thinking about opening jars and cans. If you haven't got stuff get a good multi sized jar lid opener.

I would have been surprised at one night in hospital, but I guess it depends on what part of the knee is gonna be subject of "partial" ....... as I said, mine was the medial compartment.

Good luck,

John

[BonnieMagic in reply to Hidden]

Thank you so much John for your detailed and incredibly thorough and thoughtful response. Yes I agree that pain relief will be key - unfortunately I can’t tolerate much now and definitely not Co-codamol. My pain levels are pretty bad atm as my fibromyalgia seems to have kicked in. I have a fantastic partner who is well used to looking after me so am really lucky in that respect.

The sports massage therapist sounds a great idea and I’ll definitely look into that.

Reckon I’ll have loads of questions when I go for my pre-assessment. And will check out the YouTube videos.

[Hidden in reply to BonnieMagic]

....if I can help at all as time goes on, just get in touch.

John

[BonnieMagic in reply to Hidden]

Hi John just an update and to say I hope you’re still progressing well. Am booked to have my op next Thursday (with a one night stay!). My lovely chiropractor is going to massage my knee once this is doable. Am about to check out your video suggestions. Wish me luck!

[Hidden in reply to BonnieMagic]

Hiya BonnieMagic,

Glad to get the news on your forthcoming op. Wow ! a one night stay ............. assumedly from such a short stay the surgical techniques must have been significantly advanced since I had my op which was back in the dark ages, November 2015. Even so my results have been perfect and I continue to have a dream run.

From my memory now, I think the massage process was only undertaken once the dressings had been removed and the incision area was declared infection free. Obviously a most important factor.

I think the massage process was started at about the three week mark from discharge from hospital.

I wish you well, am confident it will be, and if you need any further comments just get in touch on here.

May the force be with you.

John

[BonnieMagic in reply to Hidden]

Hi John, I wonder if you could give me a steer on the YouTube shirt videos as I am struggling to find any specifically for partial knee. All I can find is total knee exercises - I just wonder if they are radically different? The physio rang today and wasn’t particularly helpful and said I would need better physio/rehab after 2 weeks - then suggested I should pay for it! Also did you use ice therapy to help pain/swelling? Thanks Ali

[Hidden in reply to BonnieMagic]

Hi Ali,

Just off to work for a few hours, when I get home I'll have a look at my YouTube files and get back to you. I'll also see if I can find the booklet I was given at hospital illustrating all the exercises. Plse bear with me. My surgery was back in November 2015 😱😱😱😱

John

[Cat33]

Hello BonnieMagicI'm sorry I'm one of those total knee replacements people so I don't know if I have anything really helpful to say You have had a hip replacement so you know that physio is key to recovery it certainly was with me and my knee

Just take it one day at a time it all comes right I remember the physio trying to get me to lift my leg on the first day and it was like concrete and just wouldn't budge a week later I could lift it without any problem so don't despair if at first you don't do that much you will see an improvement every week

You say one night don't worry they certainly won't let you go unless you are ready I was told 3 nights for mine I only got kept in longer as my kidney function tests kept failing

There is a lovely video on You Tube by Judi Dench talking about her knee replacement I know you aren't having the total one but it's very positive and uplifting

Sorry I haven't been much help as I haven't experienced it but I do wish you all the very very best and that you will enjoy a lovely pain free summer

Take care x

[BonnieMagic in reply to Cat33]

The Judi Dench video is certainly wonderful (as is she!). Thanks

[Hidden in reply to Cat33]

Hi Cat33, Just read this old post of yours from 2 months ago wondered if you had much swelling after your TKR ? My op was this year on 11th Feb so I’m approx 6th week post op but I’m still not bending my knee too much, going to physio having CPM machine, lymphatic drainage machine and lymphatic drainage by hand massage, ice boot and compression boot. Nothing seems to get the swelling down. I think this is why I am not bending fully because of the swelling and it’s so tight. Really starting to get worried, I keep hearing everyone is different but also keep hearing you should be bending it more by now….Any advice welcome.

[Cat33 in reply to Hidden]

I look back at mine and think I was so impatient to get better My surgeon said the recovery is usually 3 months and he was so right It does take time to bend but it will come

Try not to worry too much

I'm sure in a few weeks you will see a big improvement

I've just been put on the waiting list for my other knee !

Wishing you all the very very best take it one day at a time x

[Patient007]

I had a left knee partial knee replacement in December 2021 in a private hospital and was in for 2 nights. I only wanted a spinal anaesthetic and so I was awake during the op which was my choice. I had a right knee partial replacement in day surgery in hospital in November 12th 2022. Again I opted for spinal anaesthetic. I had my op early in the morning. Had to get up as soon as the feeling came back in my legs, get dressed walk to the toilet with crutches to do a wee and then have a meal. I saw the physiotherapist and had xray and then I was ready to go home. I am 74. I live on my own and so I had to do everything for myself. The main thing is to get your pain under control as it is very painful for a long time after the operation and you have to keep up with the physio or your knee will seize up. Good luck.

[Batty1]

My cousin had a partial knee replacement couple of years ago and he was fine recovery was slow for him but that could just be him.

[NBeh]

Hi BonnieMagic

I’ve had two partial knee replacements! The procedure is called Patellofemoral Replacement as the damaged area was my knee caps!

Both operations were performed in private hospitals under NHS! The first operation was in 2017 and the second was in 2019!

I felt more pain immediately after the first surgery! I think it was because the physiotherapist visited me only a few hours after the surgery and wanted me up and walking too early and without adequate pain medications!! I think being a youngish person ( 56 years old at time of first surgery) made matters worse as I felt I was expected to get up and recover quickly! I think that caused me a lot of anxiety and exacerbated the pain and subsequently prolonged my full recovery!

With the first surgery I had the unfortunate experience of wound infection too! This was due to an unnoticed suture left in the wound!

I saw physiotherapist for a few times after the first surgery and was given exercises which i did religiously! This helped a lot with the full recovery which took me almost a year!

You’ll be glad to know ( and I was sooo too) that my second knee replacement same procedure was thankfully more straightforward and for me much less painful!

I saw the physiotherapist day after my operation and with enough pain relief in my system I was able to get on much better with those initial exercises!

I was in hospital for three days for first surgery and two days after the second surgery! Mind you I felt ready to go home after the first day but had to get the “ok” from physiotherapist after the climb of set of stairs!

I feel the second operation went much better as I made sure I was given enough painkillers!

And yes hindsight’s also was a good thing in this instance!

I feel the whole full recovery takes between six months to one year! I must say that after a year post op it all felt very good and my legs and knees felt more “normal “ !

Adequate pain relief and putting in time and effort in doing the exercises are the key things, I feel!

Hope I haven’t put you off in any way! I wish you a safe and good operation and speedy recovery!

Nancy

[Sjhoney]

Hi! I had a total knee replacement in 2020 just before lockdown. It’s the best thing I’ve ever done! I had quite a few folk telling me it would be very painful afterwards, recovery etc. I didn’t find this at all, maybe because I had been in so much pain for almost a year and I felt the pain after the op was positive?

It took about 18mths for it to settle but I love my new knee! I honestly don’t know what I would have done if the op weren’t possible.

Good luck! Hope it goes well xxx

[Hidden in reply to Sjhoney]

Hi Sjhoney, just read this old post of yours from 2 months ago wondered if you had much swelling after your TKR ?

My op was this year on 11th Feb so I’m approx 6th week post op but I’m still not bending my knee too much, going to physio having CPM machine, lymphatic drainage machine and lymphatic drainage by hand massage, ice boot and compression boot. Nothing seems to get the swelling down. I think this is why I am not bending fully because of the swelling and it’s so tight. Really starting to get worried, I keep hearing everyone is different but also keep hearing you should be bending it more by now….Any advice welcome.

[Sjhoney in reply to Hidden]

Hi!

I’m trying to remember whether I had much swelling? I had very good range of movement before my op so my recovery was straightforward. I remember the tightness but it improved with exercise.

I honestly don’t know what to advise apart from talking to a specialist.

Hope it improves!

Sarah x