Knee replacement surgery

Knee replacement surgery is an operation to replace part or the whole of the knee joint, otherwise known as knee arthroplasty. This treatment can help to relieve chronic pain in your knee joint and improve your range of movement.

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At HCA UK, you'll receive:

Appointments confirmed within 24 hours
Total knee replacement surgery at private hospitals across London, in the West Midlands and in Cheshire
Expert care provided by specialist knee consultants

What is total knee replacement surgery?

Total knee replacement surgery, also referred to as arthroplasty of the knee, is a common operation that's performed to help improve the joint's range of movement, increase stability and reduce pain levels. During this procedure, the surgeon clears your knee joint of any damaged bone and cartilage. All compartments of your knee joint are then replaced with artificial implants.

The knee’s anatomy

In order to understand what happens during total knee replacement surgery, it’s important to understand the structure of your knee:

Bones

The knee comprises three bones: the thigh bone (femur), shin bone (tibia) and kneecap (patella).

Ligaments

Ligaments are the bands of tissue that connect the thigh bone to the lower leg bones. These are called the lateral collateral and medial collateral ligaments. The medial collateral ligament (MCL) is on the inner side of your knee and this attaches the femur to the tibia. The lateral collateral ligament (LCL) runs on the outside of the knee and connects the femur to the fibula (positioned on the lateral side of the tibia).

There are also the cruciate ligaments. These are inside the knee joint and they connect the tibia to the femur. The anterior cruciate ligament (ACL) runs diagonally in the middle of the knee and its role is to prevent the tibia from sliding in front of the femur. The posterior cruciate ligament (PCL) is at the back of the knee and also sits diagonally so that it crosses the ACL to form an X shape. The PCL keeps the shin bone from moving too far backwards.

Cartilage

Articular cartilage covers the end of the femur, providing a protective layer and helping the bones glide against one another. There’s also the lateral and medial menisci, which are two C-shaped structures that act as shock absorbers and also aid movement.

However, if the cartilage wears away, the bones rub together and cause damage. This leads to pain and stiffness that affects the knee’s movement. An implant that’s added during total knee replacement surgery has smooth surfaces and replicates the bones of a healthy knee.

What happens during total knee replacement surgery?

Knee replacement surgery can be carried out under general anaesthetic or local anaesthetic. Your consultant and anaesthetist will discuss with you which will be most suitable.

Your surgeon will make a cut at the front of your knee and move the kneecap to the side. They’ll then remove any damaged bone (known as bone spurs, which are small bone growths) and cartilage in the joint.

The two menisci are removed, along with the anterior cruciate ligament. The surgeon then removes cartilage and bone from the tibia and femur before applying an artificial joint implant – made of metal, ceramic or plastic – to the tibia and femur. If the kneecap is also degraded, a plastic replacement may be implanted during the procedure too. In many cases, we use robotic technology to increase accuracy when determining the exact size and positioning of the implant.

Dissolvable stitches are then used to sew up the tissue around the knee and stitches or staples used to close the incision on the skin. Your surgeon will usually put in a small drain to remove any fluid for the first day after surgery. The whole procedure takes up to two hours.

When is a total knee replacement needed?

Several medical conditions cause knee pain. The most common is knee arthritis, which can be brought on by wear and tear (osteoarthritis), inflammatory disease (rheumatoid arthritis) or injury (post-traumatic arthritis). The risk of arthritis developing increases with age. However, gout is another type of arthritis that can cause knee pain and typically affects men over 30 and women after the menopause.

Other conditions that can cause knee pain include:

Haemophilia
Bone dysplasia
Knee deformities
Knee injuries

If the damage in the knee joint is contained to just one compartment, a partial knee replacement may be recommended. This is because it preserves more of the healthy bone and tissue than a total knee replacement.

At HCA UK we provide a broad range of knee treatments across our various locations. In 2023, 99% of our patients said they are likely or very likely to recommend us to their family and friends for orthopaedic care. And 97% of our orthopaedic patients rated us very good or excellent (2023 patient satisfaction surveys).

Alternative treatment options

While it is a common procedure, a total knee replacement is a major operation. Therefore, it's usually only recommended if other types of treatment haven’t delivered the desired results. Your consultant will initially suggest non-surgical treatments, such as:

Lifestyle changes: These can include gentle exercise or a change in diet
Painkillers: Your doctor will establish how much pain you're in and account for any other medical conditions you have before deciding on appropriate pain relief. You may be offered paracetamol or non-steroidal anti-inflammatory drugs. Stronger painkillers, such as codeine, may be recommended
Physiotherapy: Exercises designed to strengthen the knee joint and reduce pain can be tailored to suit your circumstances.

If these treatments are unsuccessful, your consultant may then recommend the following:

Steroid injections: In some cases, steroid injections may be applied to the knee joint. These contain an artificial version of the natural hormone cortisol. They can help reduce inflammation and pain in the knee
Knee arthroscopy: This minimally invasive procedure is a form of keyhole surgery that allows your consultant to see inside your knee joint. They make small incisions so that they can then pass equipment that includes a small surgical camera (arthroscope) into the knee in order to diagnose and potentially treat a range of joint problems and conditions.

The decision about whether you need a total knee replacement will be made once you have explored these other options with your consultant.

How do I know if I need knee replacement surgery?

To confirm that a total knee replacement operation will be the most effective way to treat your symptoms, your consultant will carry out a full medical assessment. This will include checks to see if alternative treatments have alleviated any symptoms. They'll also ask about any activities that make the pain worse. Your consultant will assess your knee's range of movement, strength and stability during a physical examination.

Imaging tests such as an X-ray and an MRI scan may be required to confirm the level of damage to the joint. A specialist musculoskeletal radiologist will report on the results, providing your consultant with the full picture before discussing treatment options with you.

A total knee replacement surgery may be suggested if other treatments have not been successful and:

You’re experiencing severe pain, swelling and stiffness in your knee joint and your mobility is reduced
Your knee joint pain is affecting your quality of life, including your sleep
Routine tasks, such as shopping or going up or down stairs, are difficult or impossible
Your everyday life is affected. For instance, you cannot work or socialise.

Your consultant will also consider factors such as your age, general health and activity levels, along with any risk factors. If surgery is suggested, they'll discuss the potential risks and side effects with you so you can make an informed decision on the next steps.

Read our guide to knee pain to see whether you should make an appointment to discuss knee replacement surgery with one of our knee specialists.

How do I prepare for knee surgery?

Your consultant will explain how total knee replacement surgery works and tell you what to expect on the day of your operation and the days that follow. You'll also be able to ask any questions you have about the procedure.

It's also beneficial to plan for your return home post-surgery. You’ll want to use this time to arrange for someone to pick you up from the hospital, as you won't be able to drive. It's worth seeing if someone can assist you with your day-to-day activities such as shopping while you recover too.

What is the recovery from knee replacement surgery like?

How long you stay in hospital after total knee replacement surgery will depend on your health conditions, but the average stay is three days.

The incision made for your knee replacement will be covered post-surgery with a dressing. After leaving hospital, you’ll be advised on ways to reduce the risk of any infection. For example, avoid swimming and taking baths.

We know patients often like to know when they can drive again or return to work. Timelines are dependent upon how your implant incision heals. Your consultant will advise accordingly.

Full recovery times vary between patients. This is due to the condition of your joint and surrounding ligaments, along with factors such as age and your fitness levels.

When should I see a knee specialist?

If you're experiencing pain and stiffness in your knee and would like to get a medical opinion, book an appointment with one of our specialist knee consultants. If you have private medical insurance, you’ll need a GP referral letter and a reference from your private medical insurer to hand.

They'll request any necessary imaging tests, which can typically be conducted on the same day. All treatment routes will be discussed with you before total knee replacement surgery is considered. If surgery is suggested, you'll be given all the information you need to make an informed decision.

You can browse the profiles of our expert orthopaedic surgeons with vast experience of performing total knee arthroplasty.

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Knee replacement surgery FAQs

What's the difference between a total and partial knee replacement?

The knee has three compartments: the medial compartment (inside aspect of the knee), the lateral compartment (outside of the knee), and the patellofemoral compartment (in front of the knee). In some knee osteoarthritis patients, only one compartment of the knee is affected - usually the medial compartment. The lateral compartment can be affected, but it’s less common.

A partial, or unicondylar, knee replacement, as its name suggests, replaces only the affected compartment of the knee. On the other hand, a total knee replacement involves the replacement of all three compartments. As just one compartment is replaced during partial knee replacement, the anterior and posterior cruciate ligaments are preserved. However, these ligaments are removed in a total knee replacement.

Your consultant will recommend the most effective surgery option for your specific knee condition.

How do I care for my new knee?

The lifetime of a knee implant is up to 20 years. The advice for looking after your new knee joint will depend on your lifestyle. The first three months are very important. Here are some important steps to follow after your surgery:

Raise your leg as much as possible post-surgery and follow your physiotherapy programme
Following your recovery from surgery, build up your mobility by engaging in low-impact exercise such as walking or swimming
Avoid twisting or bending down
Resist high-impact activities that put stress on your knee joint. Those who enjoy fitness activities benefit from swapping running for cycling.

How much does private knee replacement surgery cost?

The cost of private knee replacement surgery depends on the tests and treatment you require. Payment can be made through your medical insurance provider or by yourself. If you're a self-pay patient, please ask your consultant for information on our fixed-price knee replacement surgery packages for peace of mind on the costs.

Here is an estimate of how much you could expect to pay:

Hospital stay and procedure

Prices from: £14,400 subject to the specifics of your treatment as recommended by your consultant. Expected length of stay: 3 nights

Included:

Before admission

Pre-assessment

During your hospital stay

Accommodation in a private room
Routine admission tests
Patient meals
Nursing care and facilities
Theatre fees, drugs and dressings
Removal of stitches, dressing and plaster as required
Take-home medication

Excluded:

Any additional nights in hospital not described in the above
Specialist nursing above and beyond the required level of care
Any post-operative treatments/consultations which may be required
Any additional or more complex procedures not included in our initial agreement
Any readmission due to complications will result in additional charges in line with our standard prices
Personal costs including visitors’ meals and drinks as well as newspapers

Please get in touch for more information about pricing and the estimated cost of private knee replacement surgery.

Find out more about paying for your care

What are the risks of total knee replacement surgery?

As with any type of surgery, there are risks to consider. These include:

Bleeding
Infection
Blood clots in the legs or lungs
Loosening or wearing of the prosthesis
Fracture
Continued pain or stiffness

Other risks to consider include nerves or blood vessels in the area of surgery potentially being injured, resulting in weakness or numbness. Also, the joint pain may not be relieved by surgery.

The replacement knee joint could become loose, dislodged, or may not work as intended. Issues such as these could lead to the joint being replaced again, which is known as revision surgery. However, at HCA UK, our consultants have some of the lowest revision rates in the UK, based on NJR (National Joint Registry) data.

There may be other risks to be aware of, depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.

How do I book a knee replacement appointment?

To discuss your knee pain with an orthopaedic consultant who specialises in knee treatments:

Have your GP referral letter to hand as this can help speed up the booking process.
We’ll confirm your appointment on the phone or, if you have any special requests, we'll get back to you via phone or email within 24 hours.
Alternatively you can book online by finding your chosen consultant in our finder

Knee replacement Q&A

To answer many of the questions that patients have about knee replacement surgery. Read about Andrew’s and Judith's knee replacement experiences.

Andrew's story

Andrew, a 64-year-old golf professional from Kent, started swinging a golf club at the age of 12. A serious tear to Andrew’s left knee affected his mobility and threatened to keep him off the course for good.

Read Andrew's story

Judith's story

Retired physiotherapist and keen artist, Judith has had knee pain since she was in her forties. At the age of 81, after years of suffering, she made the decision to explore her options to cure her knee pain.

Read Judith's story

Why choose HCA UK for total knee replacement surgery?

At HCA UK, we typically perform over 600 knee replacements a year. This means we have a breadth and depth of knowledge about knee conditions stemming from the many patients that choose us. Our orthopaedic team has specialist knee consultants, who only treat knee conditions. Their expertise means your care is personalised to your symptoms.

Other reasons to choose us include:

Get seen quickly: We aim for one of our knee consultants to see you within 48 hours of initial contact. We can also perform any required imaging tests on the same day as your consultant appointment
Advanced care: Our orthopaedic consultants have performed nearly 2,000 robotically assisted surgeries to date, which can result in reduced pain and faster recovery times
Technologically advanced imaging: With the latest imaging technology at our disposal, we can accurately diagnose your condition and recommend the most effective treatment
Access to ITUs: Our services are supported by Intensive Care Units (ITUs), helping people with complex conditions or medical histories
Trusted: 97% of our orthopaedic patients rated our care as ‘very good’ or ‘excellent’.

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The Cost For Knee Replacement Surgery

Hospital stay and procedure

We offer self-pay patients fixed price packages for knee replacement procedures, for that extra peace of mind. Your consultant will advise you if one of the packages is suitable for your course of treatment, once you've had your initial consultation and any diagnostic scans have been reviewed. If you're eligible, there will be two options to choose from. We offer fixed price packages for both partial and total knee replacement surgery.

The package cost for the knee replacement procedure are confirmed beforehand to give you the reassurance of knowing the costs that are covered. Here’s a list of the costs covered by the package:

Standard prothesis
Nurse-led pre assessment
Medication
Hospital accommodation (incl. meals)
Inpatient nursing care
Inpatient physiotherapy

Speak with your consultant who will confirm if a fixed price package is suitable for your treatment.

Learn more about self-pay

Imaging to help diagnose knee replacement treatment

After your initial appointment with your orthopaedic consultant you may be referred for imaging of your knee joint.

At HCA UK we have over 20 diagnostic centres across our network which means we can offer imaging appointments on the same day of your consultation.

Our diagnostic centres are located at the following locations:

LONDON DIAGNOSTIC CENTRES

Central: 16 & 30 Devonshire Street, 154 Harley Street, Institute of Sport, Exercise and Health (ISEH)
North London: Wellington Hospital Outpatients, Golders Green Outpatients, and Elstree Outpatients
The City: The Shard, Old Broad Street and Canary Wharf Outpatients
West London: Chiswick Outpatients
South London: Chelsea Outpatients and Sydney Street Outpatients.

LONDON HOSPITALS

The Princess Grace Hospital, The Wellington Hospital, The Lister Hospital, London Bridge Hospital, The Harley Street Clinic and The Portland Hospital.

BIRMINGHAM HOSPITAL

The Harborne Hospital

CHESHIRE HOSPITAL

The Wilmslow Hospital

Our knee specialists

Our experts provide comprehensive, quality care from our network of treatment centres. View the profiles of our consultants who specialise in total knee replacement surgery and book an appointment with one of them today.

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