Usually, a course of conservative management will have failed to control your symptoms adequately.  The pain will be increasing and your ability to do your normal daily activities becomes more difficult.

You may have instability or catching in the knee that can cause you to fall and this may become a significant problem.

The deformity in your joint may get worse and your loss of movement may be increasing such that it would be best to have it corrected sooner rather than later.

The need and timing of your surgery will be discussed with your surgeon but ultimately the final decision rests on you and your family based on your pain and disability.

Conservative treatment:

Generally, unless the knee is so badly damaged, and function so limited, conservative management is recommended as initial management.  This may include the following options:

• Weight loss: For those overweight, this is a significant factor in improving symptoms.
• Muscle strengthening: Pain and function are improved by exercise
• Medication: This can include pain medication as well as anti-inflammatories.
• Injections: A hydro-cortisone injection may settle symptoms for a period of time.  Some patients get long-term relief over a year, whereas others do not get any relief at all.  This treatment is usually offered when patients present with very painful and /or inflamed swollen knees. The fluid is often removed at the same time.
• Walking aids: A stick can be of great value to unload the knee especially when walking longer distances.
• Orthotics: Occasionally we will suggest inserts for your shoes to try to unload the worn side of your knee. These help with about 50% of patients.

We generally do the surgery with a spinal anaesthetic and something light to sleep. At the time of surgery, we inject medication into the joint. This combination keeps patients completely pain free for the first 12-18 hours after the operation.  Usually, after that time a small percentage of patients will have mild to moderate pain and all our patients have their pain controlled with medication that is given regularly whilst in hospital.  Thus the majority of our patients report that they have had only mild pain or discomfort after the procedure and there are many who even say they never had any pain throughout their recovery. However, most patients will experience pain as they increase their activities. It is natural to want to get going quickly and so as one pushes the post-operative knee to its new limits the discomfort will let you know when to stop. We call this the “good pain”. This is because it is good that you are getting mobile again. 

Our patients generally will get up the day after surgery with the physiotherapist and are usually discharged on the 2nd or 3rd days following the surgery.  This will be determined by your condition before surgery, your age, and any medical problems that may influence your rehabilitation.  You will not be discharged until you are safe to go home.

Usually, after the stitches come out at 2 weeks, although your surgeon can advise you based on the waterproofness of your dressing.

Bathing is usually delayed for 4-6 weeks to let the wound heal well and getting in and out of a bath may be a challenge in the early stages.