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Knee Pain & Knee Replacement Surgery

Specialist assessment, non-surgical treatment and total knee replacement surgery for patients in Sheffield, from Consultant Orthopaedic Surgeon Mr Andrew Gordon.

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Private consultations at Spire Claremont Hospital, Sheffield

Understanding knee pain

What causes knee pain?

The knee joint is not simply a hinge — it is a complex joint involving flexion, extension, rotation and sliding, all controlled and stabilised by muscles and ligaments. Its bony components are the femur (thigh bone), the tibia (shin bone) and the patella (kneecap). Cartilage cushions the joint and allows smooth movement; when it wears away due to arthritis or injury, the bones rub together, causing pain, stiffness and reduced movement.

Knee arthritis and other common causes

Knee replacement may be considered if knee pain and stiffness are significantly affecting your daily activities and other treatments have not provided relief. Common causes of knee pain include:

Osteoarthritis (the most common cause)
Rheumatoid arthritis
Previously failed surgeries — such as arthroscopy or a uni (half) knee replacement

Before surgery

Non-surgical treatment & knee injections

Surgery is usually considered only when other treatments have not worked and knee pain significantly affects daily life. Non-surgical options that may be tried first include:

Weight loss (if overweight) to reduce strain on the joint
Pain-relieving medications, gels or creams
Physiotherapy and muscle-strengthening exercises
Walking aids, such as sticks or frames
Steroid (corticosteroid) injections into the knee joint

If these measures are no longer effective, surgery may be advised.

Surgery

What is a total knee replacement?

A total knee replacement (knee arthroplasty) is an operation to remove the damaged surfaces of the knee joint and replace them with artificial parts made of metal and plastic. It is usually considered only when other treatments have not worked and knee pain significantly affects daily life.

A total knee replacement is a highly effective operation. Based on outcomes reported by Andrew's own patients:

90%+of patients report significant improvement

15–20yrstypical implant durability, often longer

↑better mobility — walking, standing and stairs

↑improved independence with daily tasks

Being fully informed

Risks of knee replacement

As with all major operations, there are risks. The overall risk of serious complications is low, but it is important that you are aware of them before giving consent.

General risks of surgery

Blood clots in the legs (DVT) or lungs (pulmonary embolism)
Chest infection
Urinary infection or retention
Constipation or confusion (from medication or anaesthetic)
Reactions to medicines
Heart attack or stroke (rare)
Death (extremely rare)

Risks specific to knee replacement

Infection in the wound or joint (may require further surgery)
Stiffness or limited movement
Injury to nerves, blood vessels, ligaments or tendons
Bleeding or haematoma (occasionally requiring further surgery)
Ongoing pain despite surgery
Implant wear or loosening over time
Fracture around the knee (very rare)
Need for revision (repeat surgery)

This list is not exhaustive. Andrew will discuss the risks relevant to your individual circumstances in full before any decision to proceed with surgery.

Getting ready

Preparing for knee replacement

To give yourself the best chance of a smooth recovery, it is important to prepare well before your operation.

Stay active with light exercise to maintain strength and mobility
If you smoke, stopping before surgery reduces lung and circulation risks
Eat a balanced diet and try to maintain a healthy weight
Make sure your teeth are healthy — dental infections can increase the risk of joint infection
Prepare your home: remove loose rugs, ensure stairs have rails, and place frequently used items at waist height
Consider arranging help with shopping, cooking and household chores for the first few weeks after surgery

You will also be invited to a pre-operative assessment clinic to make sure you are fit and well enough for your operation. Tests may include blood and urine tests, an ECG, a chest X-ray and MRSA screening swabs.

An excellent guide to preparing for surgery, the Active Wait programme, was developed following a collaboration between Sheffield Teaching Hospitals and the University of Sheffield, and remains the gold standard of preparation before surgery: view the Active Wait guide →

After your operation

Recovery after knee replacement

Recovery is gradual, and everyone progresses at their own pace. Typical stages are:

0–6 weeksPain, swelling and stiffness are common. Walking aids required. Exercises are vital.

6–12 weeksPain improves, walking distance increases, daily tasks become easier.

3–6 monthsReturn to most activities, though some stiffness or swelling may remain.

6–12 monthsFull recovery for most patients.

It is normal to have swelling and warmth for several months, numbness around the scar (sometimes permanent), and clicking noises as the new joint moves. Most people can return to normal activities and enjoy walking, shopping, swimming, cycling, golf and most other pursuits. If you wish to engage in high-impact activities, please discuss them during your outpatient consultation.

You will be reviewed in clinic around 8 weeks after surgery.

Complex & revision cases

Problems following knee replacement & investigation of painful or unstable knee replacements

Not every knee replacement is straightforward. As Regional Chair of the Major Revision Knee Network and a member of its National Steering Committee, and through his NHS role within Sheffield's Lower Limb Arthroplasty Unit — a quaternary referral centre for complex revision surgery — Andrew has substantial experience assessing patients whose knee replacement:

Remains painful after the original surgery
Feels unstable or gives way
Has symptoms that have returned over time
Shows concerning changes on imaging
Is suspected of infection or loosening
Requires a second opinion

At Spire Claremont, Andrew offers specialist private assessment, investigation and advice for patients in this position. Where more complex revision surgery is required, he will advise on the most appropriate route for that care.

Discuss your situation

Common questions

Knee Replacement FAQs

It may feel uncomfortable at first. Most patients wait several months and find using a cushion helps.

Often several weeks, and it is normal to notice swelling and warmth for several months as the knee settles.

Yes — but outcomes are very successful for most patients, and recovery follows a well-understood path.

Clicking noises as the new joint moves are a normal part of recovery for many patients.

Ready to discuss your knee problem?

Arrange a consultation with Mr Andrew Gordon at Spire Claremont Hospital in Sheffield.

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Patient Information Guide: Total Knee Replacement