Knee Replacement
Knee arthritis is a major cause of disability in Australia. It can affect both your personal and professional life. There are very successful treatments available to people who suffer from knee arthritis.
Knee joint replacement may be recommended for advanced knee arthritis but there are also several non-operative treatments that should be considered.
Knee pain can often prevent you from exercising and further impact your general health. It is vital to reduce knee pain so that you are able to exercise regularly.
Maintaining a healthy and active lifestyle has many benefits, including maintaining healthy bones and joints. Active rehabilitation is an essential ingredient for helping patients treat joint pain.
Osteoarthritis is the most common form of arthritis, the most prevalent joint disorder, and it is the greatest cause of disability in Australia. 1 in 11 Australians suffer from osteoarthritis. Research shows that the prevalence of osteoarthritis is likely to continue to substantially increase over the next 20 years.
When a patient’s knee joint has worn cartilage to a point where the knee has become sufficiently painful, and non-surgical treatments are no longer effective, surgery to replace the worn knee can be considered. Joint replacement surgery removes the arthritic parts of the knee and replaces them with an artificial joint. Sometimes the entire knee joint needs replacing (total knee joint replacement) and other times only part of the knee needs replacing (partial knee joint replacement).
While often a successful treatment option for knee arthritis, there are several factors which need to be considered and discussed with your surgeon before undertaking this procedure.
Although you cannot reverse arthritis there many treatments that are extremely effective in managing the condition. These range from minimally invasive treatments to joint replacement surgeries, including:
- Painkillers
- Alternative therapies
- Physiotherapy
- Weight loss
- Joint injections
- Cartilage preservation procedures
- Osteotomies
- Partial knee replacement
- Full knee replacement
If you already have a replacement in your knee and surgery is required to replace or revise the joint, this is called revision knee replacement. Dr Stevens has expertise in the field of revision knee replacements and has also published research on how well these revision replacements perform. Dr Stevens has undertaken subspecialty training in revision knee replacements through the Royal College of Surgeons Edinburgh at the Royal Infirmary of Edinburgh Hospital ( NHS).
Surgical Fact Sheets
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Knee Arthritis and Knee Replacement Surgery
Arthritis of the knee is common in Australia. It is usually as a result of the aging process and ‘wear and tear’. If your knee is causing significant problems in your day-to-day life you may be suffering from a condition which could be helped with knee replacement surgery. Dr Jarrad Stevens is a fellowship trained knee replacement surgeon in Melbourne who regularly assess patients for knee conditions and can recommend knee surgery when required.
Knee arthritis causes significant problems for many people. Knee joint replacement is a good surgical solution for people who cannot find relief for their arthritis by using other treatments.
Dr Stevens will look at x-rays and scans of your knees to determine the amount and site of arthritis. MRI and CT scan are sometimes used to assess the arthritis in knees to determine if knee surgery is advisable. These scans can also help in the planning of difficult knee replacements.
Most people will try ways to help their arthritic knee ‘get by’. When physiotherapy, pain relief medications, weight loss and other alternative treatments are no longer working, specialist knee replacement may be able to help. It is normally advised that people try ways of dealing with their arthritis before contemplating surgery. Although knee replacement surgery is often used to treat arthritis of the knee, there are other treatments that can be considered prior to surgery.
If surgery is required for one part of the knee then a ‘partial’ knee replacement can be performed. Dr Stevens can do this robotically to achieve excellent position of the new partial knee joint.
If you and Dr Stevens decide that surgery is the best option for your arthritic knee, Dr Stevens will organise for a review by a specialist physician to make sure surgery will be as safe as possible. Blood test, a heart trace as well as other investigations maybe organised.
In general, patients who have knee replacement surgery have relief from their symptoms of arthritis and good movement of the knee. This normally means they can get back to doing the activities they enjoy. Ongoing pain, stiffness and dissatisfaction may result from knee replacement surgery – despite a good technical outcome.
Each person will recover from knee surgery in a different way. Some people will have little symptoms and good movement soon after surgery. Other patients may take months for the knee to function at its best. This is due to many factors. Age, the type of knee replacement, the reason for the knee replacement, general health and other genetic conditions will all play a role.
Partial knee replacements typically take 2 or 3 months to fully recover from. Full knee replacements normally take longer. Although the pain may subside early, swelling and tightness may take longer to settle.
A small number of patients will have difficulty bending the knee in the first 6-8 weeks following surgery. If your knee replacement is not bending beyond 90 degrees at this stage, Dr Stevens may discuss bending the knee for you under an anaesthetic to help it move more.
What to Expect after Surgery:
Once you have had your knee replacement, you may be able to begin to move the hip, ankle and knee under the instruction of Dr Stevens. Hospital physiotherapists will aim to safely have you mobilising after your surgery. This is important for your knee and general health.
A dressing will be placed over the knee following surgery. As the tissue and bone heal, a small amount of blood may appear on the dressings. This is normal. Sometimes, replacing the bandage is required to reinforce any areas that continue to bleed.
Elevate the leg for the first few days following surgery. You may be placed on blood thinning medications such as aspirin to help reduce the risk of clots.
Discharge home: After your surgery you will stay in hospital overnight and potentially for a few days. You will be discharged with pain relief tablets. If you need longer to safely walk, rehabilitation can be organised.
Pain relief: After surgery it is normal to have some pain or discomfort. The amount of surgery you have had will influence how much pain you can expect and how long you will need pain relief for. You will be given pain relief tablets to take home with you when you leave the hospital. Take these over the next week or so as you need.
Looking after the Dressing: You will need to keep the dressing clean and dry for two weeks.
Movement after surgery: You can move your foot, ankle, knee and hip straight away after surgery. Your hip will slowly be able to bend in the days that follow your operation. You may experience some pain in the weeks following surgery. You will need crutches or a frame to walk after surgery.
It is a good idea to keep moving even after your surgery, it helps your blood circulation and stops your body getting too weak. Avoid any strenuous activity for the first 2 weeks, but gentle movement and walking with your crutches is advised.
Wound review: After 2 weeks you will have an appointment with Dr Stevens to have your wound checked, any stitches will be removed. Dr Stevens will then give you advice on exercises and physiotherapy.
Driving: You cannot drive until you have had your first review appointment with Dr Stevens. He will give you an indication then when you are likely to be able to drive again
Returning to work: This depends on the type of work you do. Most surgeries will need 4-6 weeks off work, some will require longer, especially if you have a manual job.
A knee replacement operation is major surgery. Despite excellent results there are risks associated with this procedure. Fracture, dislocation, infection and damage to nerve or blood vessels are some of the more significant risks. Dr Stevens will discuss with you the risks of surgery.
+ Fever
+ Heavy bleeding or ooze from the wound
+ Increased swelling and redness around the surgery site
+ Pain in the calf muscles or difficulty breathing
If you have any of these problems, please call Dr Stevens or his rooms on 03 5752 5020
Knee Replacement: After your Surgery
Dr Jarrad Stevens is a fellowship trained knee replacement surgeon in Melbourne who regularly assess patients for knee conditions and can recommend knee surgery when required.
Knee arthritis causes significant problems for many people. Knee joint replacement is a good surgical solution for people who cannot find relief for their arthritis by using other treatments.
What to Expect after Surgery:
Once you have had your knee replacement, you may be able to begin to move the hip, ankle and knee under the instruction of Dr Stevens. Hospital physiotherapists will aim to safely have you mobilising after your surgery. This is important for your knee and general health.
A dressing will be placed over the knee following surgery. As the tissue and bone heal, a small amount of blood may appear on the dressings. This is normal. Sometimes, replacing the bandage is required to reinforce any areas that continue to bleed.
Elevate the leg for the first few days following surgery. You may be placed on blood thinning medications such as aspirin to help reduce the risk of clots.
Discharge home: After your surgery you will stay in hospital overnight and potentially for a few days. You will be discharged with pain relief tablets. If you need longer to safely walk, rehabilitation can be organised.
Pain relief: After surgery it is normal to have some pain or discomfort. The amount of surgery you have had will influence how much pain you can expect and how long you will need pain relief for. You will be given pain relief tablets to take home with you when you leave the hospital. Take these over the next week or so as you need.
Looking after the Dressing: You will need to keep the dressing clean and dry for two weeks.
Movement after surgery: You can move your foot, ankle, knee and hip straight away after surgery. Your hip will slowly be able to bend in the days that follow your operation. You may experience some pain in the weeks following surgery. You will need crutches or a frame to walk after surgery.
It is a good idea to keep moving even after your surgery, it helps your blood circulation and stops your body getting too weak. Avoid any strenuous activity for the first 2 weeks, but gentle movement and walking with your crutches is advised.
Wound review:
After 2 weeks you will have an appointment with Dr Stevens to have your wound checked, any stitches will be removed. Dr Stevens will then give you advice on exercises and physiotherapy.
Driving: You cannot drive until you have had your first review appointment with Dr Stevens. He will give you an indication then when you are likely to be able to drive again
Returning to work: This depends on the type of work you do. Most surgeries will need 4-6 weeks off work, some will require longer, especially if you have a manual job.
A knee replacement operation is major surgery. Despite excellent results there are risks associated with this procedure. Fracture, dislocation, infection and damage to nerve or blood vessels are some of the more significant risks. Dr Stevens will discuss with you the risks of surgery.
In general, patients who have knee replacement surgery have relief from their symptoms of arthritis and good movement of the knee. This normally means they can get back to doing the activities they enjoy. Ongoing pain, stiffness and dissatisfaction may result from knee replacement surgery – despite a good technical outcome.
Each person will recover from knee surgery in a different way. Some people will have little symptoms and good movement soon after surgery. Other patients may take months for the knee to function at its best. This is due to many factors. Age, the type of knee replacement, the reason for the knee replacement, general health and other genetic conditions will all play a role.
Partial knee replacements typically take 2 or 3 months to fully recover from. Full knee replacements normally take longer. Although the pain may subside early, swelling and tightness may take longer to settle.
A small number of patients will have difficulty bending the knee in the first 6-8 weeks following surgery. If your knee replacement is not bending beyond 90 degrees at this stage, Dr Stevens may discuss bending the knee for you under an anaesthetic to help it move more.
+ Fever
+ Heavy bleeding or ooze from the wound
+ Increased swelling and redness around the surgery site
+ Pain in the calf muscles or difficulty breathing
If you have any of these problems, please call Dr Stevens or his rooms on 03 5752 5020
Revision Knee Replacement Surgery:
Dr Jarrad Stevens is a fellowship trained knee replacement surgeon in Melbourne who regularly assess patients for knee conditions and can recommend knee surgery when required. Revision knee replacement surgery is a special interest of Dr Stevens.
In 2019, Dr Stevens was awarded the University of Edinburgh University Medal for research into knee revision surgery. This type of surgery is complex and often requires significant planning to ensure the best outcome.
If you have a problematic knee replacement it may require revision surgery (surgery to replace parts of the artificial knee). For this surgery to be successful a cause for the original knee replacement problem must be found.
Dr Stevens will look at x-rays and scans of your knee replacement to determine the position and look for any signs of loosening. CT scans are sometimes used to assess the alignment of the knee replacement to see if this is causing any issues. Bone scans may be organised to check for infection or loosening of your knee replacement.
If no cause for your problematic knee replacement can be found, surgery is unlikely to be successful and may not be offered.
Most people will try ways to help their problematic knee replacement ‘get by’. When physiotherapy, pain relief medications, weight loss and other alternative treatments are no longer working, are other options can be considered. Painful knee replacements without a cause of failure may be helped by: Cooled Radiofrequency Ablation.
If surgery is required to revise the knee replacement then specialist planning imaging (CT scans and X-rays) will be organised. Surgery to remove the old knee replacement and place in a new knee replacement will be performed. The results of this type of surgery are typically good. Dr Stevens has published research in the area of revision knee joint replacement – you can view this here: Dr Stevens Research Paper
If you and Dr Stevens decide that surgery is the best option for your problematic knee replacement, Dr Stevens will organise for a review by a specialist physician to make sure surgery will be as safe as possible. Blood test, a heart trace as well as other investigations maybe organised.
In general, patients who have knee replacement surgery have relief from their symptoms of arthritis and good movement of the knee. Sometimes there are issues with the knee replacement – these issues are not always able to be fixed with further surgery.
Ongoing pain, stiffness and dissatisfaction may result from revision knee replacement surgery – despite a good technical outcome.
Each person will recover from knee surgery in a different way. Some people will have little symptoms and good movement soon after surgery. Other patients may take months for the knee function to be at its best. This is due to many factors. Age, the type of knee replacement, the reason for the revision knee replacement, general health and other genetic conditions will all play a role.
Revision surgeries are considered more complex and harder to recover from then the first knee replacement.
A small number of patients will have difficulty bending the knee in the first 6-8 weeks following surgery. If your knee replacement is not bending beyond 90 degrees at this stage, Dr Stevens may discuss bending the knee for you under an anaesthetic to help it move more.
What to Expect after Surgery:
Once you have had your revision knee replacement, you may be able to begin to move the hip, ankle and knee under the instruction of Dr Stevens. Hospital physiotherapists will aim to safely have you mobilising after your surgery. This is important for your knee and general health.
A dressing will be placed over the knee following surgery. As the tissue and bone heal, a small amount of blood may appear on the dressings. This is normal. Sometimes, replacing the bandage is required to reinforce any areas that continue to bleed. Sometimes a drain to collect excess fluid will be placed into your knee at the time of surgery – this is normally removed after 2 days. You may be placed on blood thinning medications such as aspirin to help reduce the risk of clots.
Discharge home: After your surgery you will stay in hospital for several days. You will be discharged with pain relief tablets. If you need longer to safely walk, rehabilitation can be organised.
Pain relief: After surgery it is normal to have some pain or discomfort. The amount of surgery you have had will influence how much pain you can expect and how long you will need pain relief for. You will be given pain relief tablets to take home with you when you leave the hospital. Take these over the next week or so as you need.
Looking after the Dressing: You will need to keep the dressing clean and dry for two weeks.
Movement after surgery: You can move your foot, ankle, knee and hip straight away after surgery. Your knee will slowly be able to bend in the days that follow your operation. You may experience some pain in the weeks following surgery. You will need crutches or a frame to walk after surgery. It is a good idea to keep moving even after your surgery, it helps your blood circulation and stops your body getting too weak. Avoid any strenuous activity for the first 2 weeks, but gentle movement and walking with your crutches is advised.
Wound review: After 2 weeks you will have an appointment with Dr Stevens to have your wound checked, any stitches will be removed. Dr Stevens will then give you advice on exercises and physiotherapy.
Driving: You cannot drive until you have had your first review appointment with Dr Stevens. He will give you an indication then when you are likely to be able to drive again
Returning to work: This depends on the type of work you do. Most surgeries will need 6 weeks off work, some will require longer, especially if you have a manual job.
A revision knee replacement operation is major surgery. Despite good results there are risks associated with this procedure. Fracture, dislocation, infection and damage to nerve or blood vessels are some of the more significant risks. Dr Stevens will discuss with you the risks of surgery.
+ Fever
+ Heavy bleeding or ooze from the wound
+ Increased swelling and redness around the surgery site
+ Pain in the calf muscles or difficulty breathing
If you have any of these problems, please call Dr Stevens or his rooms on 03 5752 5020
Distal Femoral Replacement
Fractures around joint replacements and complex hip and knee fractures are a special interest of Dr Stevens. If you injury the bones around your knee or fracture around a knee replacement it may not be possible for that bone to heal. When fractures involve joints they can be managed with surgery to replace the injured joint.
If you have a severe fracture of the knee or a fracture around an artificial knee then surgery to replace the knee and femur bone may be required – this is called: distal femoral replacement. Dr Stevens assesses patients for knee conditions and can recommend this type of knee and femur surgery when required. Dr Stevens has published the results of this type of surgery an his paper can be found here: Dr Stevens Research Paper
Dr Stevens can review x-rays of your femur and knee to determine the amount and size of your injury. It may be necessary to organise specialist MRI or CT scans which help in planning surgery.
If you and Dr Stevens decide that surgery is the best option for your injury, Dr Stevens will organise for a review by a specialist physician to make sure surgery will be as safe as possible. Blood test, a heart trace as well as other investigations maybe organised.
What to Expect after Surgery:
Once you have had your distal femoral replacement, you may be able to begin to move the hip, ankle and knee under the instruction of Dr Stevens. Hospital physiotherapists will aim to safely have you mobilising after your surgery. This is important for your hip and general health.
A dressing will be placed over the knee following surgery. As the tissue and bone heal, a small amount of blood may appear on the dressings. This is normal. Sometimes, replacing the bandage is required to reinforce any areas that continue to bleed.
Elevate the leg for the first few days following surgery. You may be placed on blood thinning medications such as aspirin to help reduce the risk of clots.
Discharge home: After your surgery you will stay in hospital overnight and likely for a few days. You will be discharged with pain relief tablets. If you need longer to safely walk, rehabilitation can be organised.
Pain relief: After surgery it is normal to have some pain or discomfort. The amount of surgery you have had will influence how much pain you can expect and how long you will need pain relief for. You will be given pain relief tablets to take home with you when you leave the hospital. Take these over the next week or so as you need.
Looking after the Dressing: You will need to keep the dressing clean and dry for two weeks.
Movement after surgery: You can move your foot, ankle, and hip straight away after surgery. Your hip will slowly be able to bend in the days that follow your operation. You may experience some pain in the weeks following surgery. You will need crutches or a frame to walk after surgery.
It is a good idea to keep moving even after your surgery, it helps your blood circulation and stops your body getting too weak. Avoid any strenuous activity for the first 2 weeks, but gentle movement and walking with your crutches is advised.
Wound review: After 2 weeks you will have an appointment with Dr Stevens to have your wound checked, any stitches will be removed. Dr Stevens will then give you advice on exercises and physiotherapy.
Driving: You cannot drive until you have had your first review appointment with Dr Stevens. He will give you an indication then when you are likely to be able to drive again
Returning to work: This depends on the type of work you do. Most surgeries will need 4-6 weeks off work, some will require longer, especially if you have a manual job.
A distal femoral replacement operation is major surgery. Despite excellent results there are risks associated with this procedure. Fracture, dislocation, infection and damage to nerve or blood vessels are some of the more significant risks. Dr Stevens will discuss with you the risks of surgery.
+ Fever
+ Heavy bleeding or ooze from the wound
+ Increased swelling and redness around the surgery site
+ Pain in the calf muscles or difficulty breathing
If you have any of these problems, please call Dr Stevens or his rooms on 03 5752 5020
Cooled Radiofrequency Ablation: Knee
If your knee is painful and causing significant problems in your day to day life you may be suffering from arthritis. Dr Stevens regularly assess patients for knee conditions and can recommend knee surgery when required. Sometimes it can be difficult to know how many of your symptoms are coming from the arthritis, especially if you have back pain, hip pain or pain which is not typical for knee arthritis.
Non-surgical management of knee pain and arthritis includes weight loss, activity modifications and physical therapy. Other treatments include pain relief medications, anti-inflammatory medications and injections. An injection of local anaesthesia and corticosteroid into the knee can help but repeated injections can cause damage to cartilage.
Cooled Radiofrequency Ablation targets nerves around the knee to prevent them from sending pain signals: Research Paper Link
The suprapatella branch (Nerve to RI supplying the subpatella plexus) superior lateral, superior medial, inferior medial genicular nerves are targeted by radiofrequency ablation probes. Local anaesthetic is placed on the nerves after they have been deactivated.
If you and Dr Stevens decide to proceed with Cooled Radiofrequency Ablation of the knees then you will need a day admission to hospital. Dr Stevens’ anaesthetist will look after you with sedation during the procedure. Dr Stevens uses an Image Intensifier machine to locate the region of these nerves and then uses Cooled Radiofrequency Ablation to deactivate these nerves.
Once you have had your knee Radiofrequency Ablation, you may be able to begin to move the hip, ankle and knee under the instruction of Dr Stevens. Hospital physiotherapists will aim to safely have you mobilising after your procedure. This is important for your knee and general health.
A dressing and bandage will be placed over the needle sites.
Discharge home: After your procedure you will stay in recovery until you can sit up and safely begin to move around. When you are comfortable you can be discharged home with pain relief tablets.
Pain relief: After Cooled Radiofrequency Ablation it is normal to have pain or discomfort as the nerves have been targeted. You will be given pain relief tablets to take home with you when you leave the hospital. Take these over the next two to three days as you need.
It is a good idea to keep moving even after your surgery, it helps your blood circulation and stops your body getting too weak. Avoid any strenuous activity for the first 2 weeks, but gentle movement and walking is advised.
Review: After 2 weeks you will have an appointment with Dr Stevens to have your procedure sites checked. Dr Stevens will then give you advice on exercises and physiotherapy.
Driving: You can drive the day after your Radiofrequency Ablation if your knee feels strong enough.
Returning to work: This depends on the type of work you do. Most injections need 1-2 days off work.
+ Fever
+ Heavy bleeding or ooze from the wound
+ Increased swelling and redness around the injection site
+ Pain in the calf muscles or difficulty breathing
If you have any of these problems, please call Dr Stevens or his rooms on 03 5752 5020