Total Knee Resurfacing

Is osteoarthritis stopping you doing the things you love? Total knee resurfacing transforms lives by dramatically reducing pain and restoring movement.

Osteoarthritis and you

In a healthy knee joint, the bones of the knee are covered in a type of cartilage that helps them glide smoothly. But when the cartilage begins to wear away, it leaves bone to grind on bone. This is osteoarthritis.

Osteoarthritis is a degenerative condition – it gets worse over time as more of the tissue that protects the knee is worn away. If you have knee osteoarthritis, what once began as mild discomfort you could manage with painkillers becomes something more:

Pain worsens, to the extent that you may find it difficult to walk, kneel, drive or climb the stairs as you once did
Your knee may feel stiff or swollen, making it difficult to bend or straighten your leg
Your knee may make cracking, crunching or grating sounds when you move
You may have difficulty sleeping

> Discover more about osteoarthritis, YKC & you

Find out more about arthritis of the knee in this short video:

As osteoarthritis progresses, many people find they ‘pay’ for the things they love doing – walking the dog, hiking, skiing, a round of golf – the day after. Eventually, they may not be able to do them at all.

The effect of osteoarthritis isn’t only physical. The chronic pain, together with its impact on everyday life, means osteoarthritis has a mental impact. Symptoms of depression are not uncommon.

If any of the above feels familiar, knee resurfacing could transform your life.

What is knee resurfacing?

Knee resurfacing replaces worn sections of bone within the knee with metal and plastic implants that mimic the effect of cartilage-covered bones in a healthy knee. Resurfacing also protects the kneecap, the ligaments and other soft tissues.

The result is a dramatic reduction in pain and discomfort and a dramatic improvement in function, meaning you can do many (and for many patients, all) of the things your osteoarthritis stopped you doing.

What is total knee resurfacing?

The knee is a complex joint which comprises three ‘compartments’.

Find out more about the anatomy of the knee in this short video:

Where the osteoarthritis is confined to a single area, you may be suitable for partial knee resurfacing, rather than total knee resurfacing. There can be advantages to this, and you can find more about these on our partial knee resurfacing page.

Where partial resurfacing is not a viable option because osteoarthritis affects more than one compartment of the knee, total knee resurfacing may offer a solution.

Is total knee resurfacing right for me?

Knee resurfacing is a surgical procedure. As with any surgical procedure, it’s one that should be considered only after non-surgical alternatives have been exhausted.

When we meet patients for the first time, they’ve usually exhausted most (if not all) of these alternatives. Over the counter painkillers may no longer be effective. Physiotherapy, weight loss and changing behaviour – all of which can be effective for some – may not be effective (or be of limited effectiveness) for you.

At your consultation, we’ll explore the right treatment for you in the following ways:

Your experience: Listening to patients is such an important part of the diagnostic process. Your experience of pain, the changes you’ve had to make to your life, and your quality of life are all factors that can help us understand whether other treatments may be appropriate, or whether surgery is the best next step.

Physical examination: Amongst other things, we’ll look at the way you move and check for signs of pain or swelling of the knee joint.

Scans: An x-ray will reveal signs of arthritis and support our diagnosis. We may use other scans (such as MRI, which enables us to see soft tissues) in certain cases.

What difference will total knee resurfacing make to my life?

When we look at the outcomes of total knee resurfacing, two factors matter most to patients: pain reduction and function.

Pain reduction: Studies vary, but what is consistent is that the vast majority of patients report a significant reduction in pain after total knee resurfacing. Some report complete pain relief. The variation comes from the number of patients reporting high levels of satisfaction with their ‘new knees’. Some studies put that at above 75%; some at above 90%. Yorkshire Knee Clinic surgeons consistently achieve satisfaction levels of more than 90%with total knee resurfacing and more than 95% with partial knees.

Function: By ‘function’ we mean mobility. To what extent will your resurfaced knee enable you to get back to doing the things you love? Again, figures vary depending on the measures used, but countless studies show substantially improved function in a significant majority of patients. Many return to high level activities.

What will happen during and after my operation?

1. Where will my knee resurfacing operation take place?

Yorkshire Knee Clinic’s knee resurfacing specialists operate from three hospitals, and you can choose the surgeon and hospital most convenient to you:

The Duchy Hospital Harrogate
Nuffield Hospital Leeds
Spire Methley Park Hospital

2. Will I need a general anaesthetic?

Total knee resurfacing will take place under a spinal (which means you’ll be awake during the procedure) or general anaesthetic. Both options are usually available and offered by our anaesthetists. The procedure typically takes 1-2 hours.

3. How long will I spend in hospital?

Most patients will be in hospital for a one night only. During that time you’ll be encouraged to mobilise, taking a few steps to build confidence, prevent complications like blood clots, and promote faster healing.

4. Will it be painful?

Yes. Once the anaesthetic has worn off, you can expect your knee to be very sore for a few weeks (and especially the first few days). Most people find that, with the medication they are given, the pain is manageable. After a few days the acute pain begins to subside. Many patients feel they can manage entirely without painkillers after six to eight weeks although pain may still disrupt sleep during this period.

YKC’s Jim Newman explains more about pain after knee resurfacing

5. How quickly will I recover from total knee resurfacing?

With assistance, you should be able to start walking small distances right away.

At six weeks, when you will have a check-up with your Yorkshire Knee Clinic consultant, most patients are able to walk unaided for a mile or two. They are normally driving again. Some may have returned to work (depending on their job). It’s not uncommon for patients to be walking significant distances by this point, although they may still feel some discomfort afterwards. This can be managed by ice, rest and over-the-counter painkillers.

Full recovery from knee resurfacing can take up to six months. It’s worth remembering that, however good your knee feels at six weeks, it will feel better still by six months.

Total knee resurfacing – FAQs

How long will my knee implant last?

For patients who undergo total knee resurfacing, research suggests 90% will find their knee still functions well after 15 years*. 4 in 5 patients will get 25 years or more out of their knee implant.

* The Lancet

What are the risks of total knee resurfacing?

The risk of complications is low but, as with all surgery, knee resurfacing is not completely risk free. That’s why your Yorkshire Knee Clinic consultant will always want to exhaust non-surgical, less risky options before making the decision to operate.

Risks and complications include:

Wound infection
Blood clots (deep vein thrombosis or pulmonary embolus)
Swelling around the knee
Nerve damage
Stiffness in the knee joint
Implant failure

The risk of a major complication is around 2-3%.

Is total knee resurfacing suitable for someone of my age?

There’s no upper age limit for knee resurfacing. While your general health will be a consideration in deciding whether surgery is right for you, that isn’t something that is defined purely by age.

Things are a little different for younger patients. When considering surgery, your consultant will discuss future options. If a total knee resurfacing implant loosens or wears out it can be revised to a revision knee replacement in the future. These can themselves normally be revised and so there are more options for the future than there were more than a decade ago. Historically surgeons were reluctant to offer knee resurfacing/replacement to patients under the age of 60. Nowadays, many patients under the age of 50 are treated with partial or total knee resurfacing as long as they accept the potential for requiring revision surgery in the future.

Your Yorkshire Knee Clinic consultant can discuss the relative risks and benefits of surgery so you can make an informed decision.

Where appropriate, partial knee resurfacing may offer younger patients an excellent treatment option, which can then be followed by total knee resurfacing.

How much does total knee resurfacing cost?

Costs vary by hospital, surgeon and patient. On average, you can expect to pay up to £17,000. This includes:

Hospital and theatre costs
Knee implant costs
Medication
Surgeon and anaesthetist Fees
Post-operative x-rays and check-ups
Physiotherapy

Will my knee feel as good as it used to?

Most patients notice a big improvement compared to living with an osteoarthritic knee. Between 1 in 5 and 1 in 10 patients do report some continuing knee pain after total knee resurfacing. Some function may not be quite as it once was – kneeling can be problematic, for example, although most patients are able to kneel after a couple of months. In most cases, however, any pain or loss of function remains a significant improvement on the position pre-resurfacing.

Partial or total knee resurfacing: which is better?

It’s something of an academic question, because total knee resurfacing may be the only viable option for around 50% of patients.

Yorkshire Knee Clinic’s view, however, is that where a patient would be a suitable candidate for partial knee resurfacing, that would be the better option. Where total knee resurfacing is the only viable option, however, it is a perfectly good one.

Why Yorkshire Knee Clinic?

According to the National Joint Registry, the average number of total knee resurfacing procedures carried out by surgeons in England, Wales and Northern Ireland over the past three years was 115.

Between them, in the same space of time, the three surgeons of Yorkshire Knee Clinic completed almost 500.