Unfortunately, as is the case with all surgery, there
could be potential problems with a knee replacement.
YOUR KNEE CONSISTS OF THREE COMPARTMENTS: General complications, specifically cardiovascular • Patello-femoral compartment: between the
problems, are a small possibility. With the knee we are
specifically concerned about the possibility of an infection.
• Medial compartment: between the inner half
Statistically the chances are remote; approximately 0.3%.
of the upper and lower leg. • Lateral compartment: between the outer half
In an effort to reduce possible complications to a minimum we will arrange for a pathologist to do a few
Only one of the three compartments (medial, lateral
special investigations, specifically to rule out the small
or patellofemoral) in your knee is worn. The other two
possibility of a low grade infection in another part of
the body. We may also arrange for you to be seen pre- operatively by the anaesthetist and if he feels it is
With a uni-compartmental replacement, only the
indicated, by a physician or cardiologist.
surface of the damaged compartment is replaced. This differs from a total knee replacement, where all three compartments are replaced.
MEDICATIONAnti-inflammatory drugs like Voltaren, Brufen, etc.
ADVANTAGES AND DISADVANTAGES increase the incidence of post-operative bleeding and
it is important that the use of this type of medication
A uni-compartmental replacement can be compared
should be stopped for at least 3 days before the
with a total knee replacement as follows:
operation. Platelet aggregation inhibitors such as Disprin, Plavix, etc should be stopped 10 days before
the operation. If you use Warfarin you will need to
stop taking it 4 days before the procedure and replace
• Recovery slightly faster and easier.
it with heparin. Women on hormone therapy should
• Functionally it gives a better result, especially
stop the use of this for a week before and 2 weeks
considering range of movement and the 'feeling'
If you usually have a drink at night, please continue
• Easy to convert to a total knee replacement.
doing so while in hospital; it will speed up your recovery. The hospital however does not supply liquor;
• The non-replaced compartments of the knee can
It is important to plan your homecoming. Remember
deteriorate over time which might necessitate
• Although a smaller procedure, a uni-compartmental crutches. You will be able to negoti-
replacement is technically more difficult.
• The lifespan of a uni-replacement is slightly shorter
than that of a total knee replacement. The life
expectancy of a uni-replacement is approximately
10 - 15 years compared to the 15 - 20 years of a
total replacement. It is however very easy to convert
a uni-replacement to a total replacement.
some moral support during the first two weeks at home.
quite self-sufficient. You can shower on the 3rd day
after the operation after a water-tight dressing is applied
You will be admitted to the hospital at 14h00 the
to the wound. The stitches do not need to be removed as
afternoon before the operation. To reduce the possibil- they are beneath the skin and dissolve on their own.
ity of thrombosis, heparin injections are used the night before surgery. We usually continue with this therapy
Bending the knee for the first few weeks after the
for approximately 1 week after discharge.
operation is often quite difficult. It is therefore impor-tant to continue with your knee exercises at home as
The operation is normally performed under a spinal
the physiotherapist has shown you. Make a point of
anaesthetic where an injection is given into the lower
going for a short walk every day, preferably outside.
spine causing you to lose all sensation in the lower
You can start driving your car as soon as you feel you can
extremities. This is usually combined with a very light
do so safely; usually about 2 - 3 weeks after the operation.
anaesthetic to make you unaware of the activities in the theatre. The anaesthetist will also perform a femoral nerve block in theatre after we have finished
the procedure. This will help to provide excellent pain
We expect that you would walk well within 3 months.
relief post-operatively, but will also mean that your
It is however important to understand that healing is a
thigh muscle will not function until the local anesthetic
slow process and that there will be progressive
wears out. It usually lasts 24-36 hours. This means
improvement in the knee for up to a year after the
that you will only start to walk on the second day after
operation. We do not want you to jump, run or sit on
your haunches. There are no restrictions on sports like bowls, golf and recreational doubles tennis. Walking,
A uni-replacement takes approximately 1 hour.
swimming and cycling would also be fine. You can
For the first 24 hours after the operation you will be
expect to feel a 'click' in the knee at times. This is
nursed in a high-care unit. You should feel comfort-
normal and is caused by the metal on the one side
moving on the plastic on the other side. You will probably also have decreased sensation on the scar over the knee. This is the result of cutting through
the thin nerves in the skin when opening the knee.
On the day of the operation you would be on an
This numb area will gradually get smaller but s
intravenous drip through which we infuse antibiotics
ensation in that area may not totally return.
and pain medication. There will also be drainage tubes in the knee. We use medication to decrease the
It is advisable not to undertake any long haul
amount of bleeding, making the need for a blood
(international) flights for the first 3 months after the
transfusion highly unlikely. The intravenous drip and
operation due to the risk of a thrombosis. Local flights
the wound drains are usually removed on the 1st day
are not a problem. The artificial joint will trigger the
metal detectors at security check-points at the airport. It is advisable to wear loose-fitting clothes that allow
The physiotherapist will visit you daily from the day of
you to easily show your scars if you are requested to.
the operation. The rehabilitation exercises may seem simple and easy but it is of the utmost importance that Should you need any other surgery in the future,
they should be done regularly and correctly to ensure
especially dental, you should inform your doctor/
a quick and thorough recovery. You will start walking
dentist that you have had a knee replacement and
on the second day after the operation and every day
that he/she should prescribe a prophylactic antibiotic.
you should note an improvement in your walking ability.
If you are not allergic to penicillin we suggest one of the following: Cefalexin (e.g. Keflex), Cefradine
The hospital stay for a uni-replacement is approxi-
(e.g. Cefril) or Amoxacillin (e.g. Amoxil). The dose is
2 grams one hour before the procedure. If you are allergic to penicillin we suggest: Clindamycin (e.g.
Dalacin-C) 600mg orally one hour before the procedure.
You will receive a supply of medication to take home upon discharge from the hospital. This will include
PLEASE NOTE: under NO circumstances should
pain medication, antibiotics and drugs to decrease the anyone, except an orthopaedic surgeon, chances of a blood clot. For the first 4 weeks we
insert a needle into your replaced knee,
would prefer you to walk using two crutches. However, either for an injection or aspiration. during this period you can take full weight on the operated leg. By the day of discharge you should be
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