At Benenden Hospital Trust we understand the suffering, anxiety and disruption that can be caused by having problems with a knee joint. That’s why we offer rapid access to our consultations and treatments for private insured and self-funded patients and to Benenden members as discounted self-paying patients. Patients can also access our knee services via the NHS e-Referral Service, receiving the same high quality of treatment and care.
Using state-of-the-art theatres, single en-suite rooms and a rigorous approach to infection control, means we have an unblemished record when it comes to serious cases of infection, such as MRSA or C-diff, as defined by the Department of Health.
Our comfortable environment in the heart of Kent, caring staff and use of the Rapid Recovery Programme means we will help you achieve a speedy recovery, allowing you to get back on your feet as soon as possible.
To find out more our Private Patient Co-ordinators will be pleased to assist with your enquiry.
Call: 01580 242 521
There are many reasons for knee replacement. It may be required if one (or both) of your knee joints becomes damaged and causes you persistent pain or problems with everyday activities.
Normally the surfaces of a knee joint are lined with cartilage which helps the joint move smoothly, with a high degree of movement and without causing pain. But when the joint surfaces become worn, normal movement becomes painful as the ends of the bones start to rub or grind together and the joint becomes stiff and inflamed.
There are many reasons why the joint lining can become worn or damaged; some common reasons are explained here.
Osteoarthritis in the knee occurs when the cartilage wears, resulting in the bones within the joint rubbing against each other. This leads to increasing pain and restricted movement of the joint. The bones may compensate by growing thicker and producing bony outgrowths to try to repair themselves, but this can cause more friction and pain. Osteoarthritis is the most common reason for knee replacement surgery.
Rheumatoid arthritis can also be a factor. This is where the body’s own immune system (the body’s defence against infection), attacks the lining of the joint, resulting in stiffness and pain.
Traumatic arthritis results from a serious knee injury, such as a fracture, ligament damage or meniscus tear. The impact of the accident also causes mini trauma to the cartilage which, over time, develops into osteoarthritis which causes knee pain and stiffness.
Damage to the ligaments in the knee are very common in sports that require stopping and starting or quickly changing directions. These extreme forces on the knee can result in torn ligaments. The anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) are the most often injured, but the posterior cruciate ligament (PCL) and the lateral collateral ligament (LCL) can also be injured.
Knee replacement surgery (arthroplasty) is usually only recommended after non-surgical treatments such as pain relief, therapy and muscle strengthening have been tried first. It involves replacing a damaged, worn diseased knee with an artificial joint.
The first complete knee replacement took place in 1968 and it is now a common procedure with very predictable and successful outcomes. Most people receiving a replacement knee are over 65, with women being slightly the more likely recipients. With care, a replacement knee joint will last for 15 -20 years.
Revision knee replacement surgery (replacing the artificial joint) is usually more complicated and often not as affective. This is one reason why knee replacements are less likely to be given to younger patients.
There are two types of surgery performed at Benenden Hospital, depending on the condition of the knee:
Total knee replacement is when both sides of the knee joint are replaced.
Partial knee replacement (or unicompartmental replacement) is when only one side of the joint is replaced. This is a smaller operation with a shorter hospital stay and recovery.
Preparing for a successful knee operation
Your initial consultation will, where possible, include tests and diagnostic imaging (X-rays or MRI scans) and an assessment of your fitness for anaesthesia on the same day, to reduce the number of visits you need to make to the hospital You'll also be entered into our Rapid Recovery Programme.
It may be recommended that you start an exercise programme to strengthen your muscles around the joint and increase flexibility before surgery as this can benefit the recovery time after your operation.
What to expect on the day of surgery
On the day of your surgery, you'll meet your consultant and anaesthetist before you're prepared for theatre. Our knee replacement surgery is performed by a highly-skilled team of consultants. The operation itself takes up to an hour and a half, after which you’ll be taken to the recovery room where you’ll be observed until you’re fit to return to your private room.
After your operation
Your recovery in hospital usually takes around three days and is managed by a highly skilled team of nurses. Every day you’ll be visited by a physiotherapist who’ll help you regain mobility through carefully planned exercise. Your knee will be tender and painful at first and we’ll only let you leave hospital once we're happy that it’s safe for you to do so.
Most people make a good recovery but an artificial knee never feels the same as a normal knee. For instance, kneeling down is not recommended as it is usually uncomfortable. A replacement can also wear out over time.
Advanced osteoarthritis of the knee is the most common reason for a knee replacement. It tends to affect middle aged or older people, with symptoms including loss of movement and mobility with either mild pain or severe discomfort.
Before recommending a knee replacement your consultant will normally explore all the non- surgical options, such as:
- Muscle strengthening around the joint
- Support through braces to improve knee alignment, to provide additional stability and to prevent the knee from giving out during activity
- Pain relief through medication, injections and heat as well as less invasive surgery.
- Weight loss, if appropriate, to reduce stress on the knee.
Knee surgery would only be considered if your knee is significantly affecting the quality of your life, causing pain and interfering with day to day activities. Your consultant will discuss your medical history, assess your range of movement and muscle strength, and look at X-rays of the damage within the joint before recommending the best course of treatment.
If only one ‘compartment’ of your knee is affected, your consultant may decide on a partial knee replacement rather than a complete knee replacement.
The Rapid Recovery Programme allows your joint the time it needs to properly heal and regain its full function, while giving you the best chance of making a full and active recovery.
The Programme focuses on getting you safely out of bed and starting to move the joint as soon as possible with the support of pain relief management.
The Rapid Recovery Programme allows quick yet safe recovery from a hip replacement operation. Through the Programme the average stay in hospital is reduced, however a patient never leaves Benenden Hospital until they are fit and safe to discharge.
Recovery times vary depending on the individual patient and the type of surgery carried out. It’s important to follow the advice given by your surgeon and physiotherapist.
Initially you’ll have a large dressing on your knee to protect your wound and drains to remove blood from the operation site. Nursing staff will change your dressing regularly.
You’ll be encouraged to get up and walk about as quickly as possible. If you’ve had minimally invasive surgery, or are on our Rapid Recovery Programme, you may be able to walk on the same day as your operation. At first you’ll walk with a frame or crutches and most people can walk independently with sticks after about a week.
If your GP wants to refer you to a consultant for a possible joint replacement, you can choose to be treated at Benenden Hospital.
If you are Privately Insured or Self-Funded
For a competitive quote call our dedicated Private Patient Co-ordinators at Benenden Hospital, on 01580 242 521. If you're privately insured, you will need to call your insurance company to check that your treatment at Benenden Hospital is covered. Payment for treatment is your responsibility, so always check that every stage of treatment is covered in advance. Once you are happy with the quote you can book your first appointment through the Private Patient Co-ordinators on 01580 242 521. You will need to ask your GP to write a referral letter which should be sent to the Private Patient Office at Benenden Hospital.
If you are a member of Benenden
You can access treatment as a self-funded patient receiving an ‘exclusive to members’ reduction of 10% on the full private cost of the treatment. For a competitive quote call our dedicated Private Patient Co-ordinators at Benenden Hospital, on 01580 242 521. Once you are happy with the quote you can book your first appointment through the Private Patient Co-ordinators on 01580 242 521. You will need to ask your GP to write a referral letter which should be sent to the Private Patient Office at Benenden Hospital.
If you are an NHS patient
NHS patients can choose to have their treatment at Benenden Hospital through NHS Choice. Your GP may recommend that you come to Benenden Hospital, or alternatively you can specify that you wish to be treated here. Your GP, or you can make the booking at NHS e-Referral Service at https://www.ebs.ncrs.nhs.uk/ or you can call them on 0345 608 8888. Please note: Treatment as an NHS patient will be to the current government guidelines of within 18 weeks from referral.
Your GP can also send your referral via fax or post to our Patient Appointments Department.
Total knee replacement surgery is now one of the most routine and successful surgeries. Most patients will be able to take part in daily activities that they may have been forced to give up.
Total knee replacement surgery involves replacing all the damaged sections of the knee with artificial parts, where the majority of the knee has been affected. The new knee has a metal part fitted to the end of the thigh bone (femur) and a metal and plastic spacer on the upper end of the shin bone (tibia) and if required a plastic button on the knee-cap. The back of the knee-cap (patella) may also be resurfaced if required.
This surgery should help to significantly reduce joint pain and swelling, and improve your range of mobility. You should be able to resume near normal movement after only 6-8 week recovery period. Some people resume normal activity even sooner.
Total knee replacement surgery is performed at Benenden Hospital by a highly skilled team of orthopaedic consultants. Patients may also be offered Signature Personalised Patient Care, which uses MRI (magnetic resonance imaging) technology to create personalised positioning guides for total knee replacement.
The Signature system uses an MRI (magnetic resonance imaging) scan to create a three-dimensional joint reconstruction, which enables the surgeon to carefully plan your knee replacement before the operation itself.
In the past, surgeon planning has typically been based on two-dimensional X-rays.
With the MRI and Signature personalised positioning guides, surgeons have access to a greater level of detail and precision for implant position and alignment before the procedure. This allows for personalised implant positioning and may help enhance surgical efficiency.
A partial knee replacement (unicompartmental) is an option for some patients who have osteoarthritis of the knee. Your consultant may recommend this option if the arthritis has effected only a single compartment (inside, outside or front) of your knee.
The unicompartmental knee replacement, replaces only the damaged compartment with a metal or plastic joint, whilst the healthy bone and cartilage in the rest of the knee are retained. In most cases it offers quicker recovery, less pain following surgery and less blood loss. Many patients also report that because they still retain part of their bone and cartilage, the knee replacement feels more natural than a total knee replacement.
Unicompartmental knee replacement surgery is performed at Benenden Hospital by a highly skilled team of orthopaedic consultants.
Arthroscopic (keyhole) surgery is generally easier for patients than open surgery as the patient can usually go home on the same day as the operation. Knee arthroscopy may correct your knee problems and remove the need to have a large incision, a longer stay in hospital and more discomfort.
What is knee arthroscopy?
Knee arthroscopy (also called keyhole surgery) is a procedure that allows the surgeon to look inside the joint, examine what’s causing the problem and remove and repair damaged cartilage and/or bone fragments. It requires a small incision next to the joint and perhaps one or more small incisions to allow a probe or surgical instruments to be inserted.
Before being considered for a knee replacement it is likely that you will be given a number of non-surgical treatments and medications to see if they are effective in relieving your knee pain and stiffness caused by osteoarthritis.
These may include:
- Painkillers, including non-steroidal anti-inflammatory tablets, if your knee joint is also inflamed
- Steroid injections may help in some cases, but this is not a long term solution
- Pain-relieving creams, gels and rubs are available over the counter or on prescription
- Exercise may help too, by strengthening the surrounding muscles
- An arthroscopy (keyhole surgery) may be recommended to clean out the knee joint and provide relief for a limited amount of time. Stiffness and pain may improve for a short-term solution.