There are a number of causes for knee problems. The most common is osteoarthritis (wear and tear, generally related to age). Rheumatoid arthritis is a condition whereby the lining of the joint becomes extremely inflamed and starts to destroy the healthy articular cartilage. A knee replacement is also called a, knee arthroplasty (the technical term). It can be a Total knee arthroplasty ( a whole knee replacement) or a Uni-compartmental knee replacement (half a knee replacement). Its aim is to alleviate pain and provide a near-normal range of movement.

In some cases it may be best to replace both knee joints during the same operation. This tends to be in some patients who are confined to a wheelchair or who suffer from extreme stiffness or pain and think that rehabilitation after one may be made extremely difficult because of arthritis in the other knee. Recovery and rehabilitation tend to be a little bit more difficult and uncomfortable in the first few weeks after surgery, but there is the advantage of less total time off work for recovery.

The decision for surgery should be made by the patient in conjunction with the orthopaedic surgeon. In the vast majority of cases, the decision should be made by the patient, only rarely should an orthopaedic surgeon persuade a patient to consider a knee replacement sooner rather than later (e.g. concerns that the bone is wearing out, which would mean that the surgical technique becomes significantly more difficult and this may result in a less successful outcome). Most patients deciding on surgery will be having pain on a daily basis. There is often a constant underlying baseline ache, which is made worse by certain movements, activities or positions (e.g. going for a walk, going up or down stairs, getting in and out of a car or trying to put on shoes and socks).   In the first instance, simple pain relief such as Panadol may help with these symptoms. Often patients who are able to take anti-inflammatory medication will find good relief of their symptoms and sometimes stronger painkillers, which are prescribed by a medical professional, will be required as the knee pain worsens. Quite often, the pain will get worse at night and may even keep people awake, or wake people up from sleep.Physiotherapy and various activities and movements, such as swimming, may also be beneficial to the joint and may help relieve some of the pain and stiffness. The stiffness typically makes it difficult to sit in a low chair, go up or down stairs easily, put on shoes and socks and paint or clip toenails / wash between the toes.   Whilst painkillers and anti-inflammatory medication, exercise modification and walking aids, e.g. walking stick may help the symptoms, they will not cure the diseased knee. The knee will slowly deteriorate and it is at this point when non-operative measures have been tried and exhausted, most orthopaedic surgeons would recommend the consideration of joint replacement.