Welcome to the Patient Journey App, a place dedicated to your knee replacement surgery

The Orthopaedic Department is staffed by a multi professional team including Medical staff, led by the Clinical Director, Nurses, led by the Matron, Physiotherapists, Occupational Therapists and other supporting agencies.

Patient consent

Our commitment to you is to inform you of all aspects of the intended procedure you are to undergo. You will then be required to ‘consent’ in writing to your procedure. Following your individual consultation with your surgeon, should you wish for further clarification of any aspects of which you have been informed, please ask the nurse who will be happy to clarify issues.

Data Protection Act

Your name is entered onto our computerised database, enabling us to keep effective clinical records. Under the Data Protection Act you have the right to view any records held by Yeovil District Hospital. Please ask a nurse should you wish to access them. If you or your representative wish to have copies then you will have to give your written consent for a copy to be made. You will have to pay for this copy.

Chaperone

You have the right to have a chaperone provided by the Hospital, during any examination and certain procedures. You may choose a family member or close friend or carer. You also have the right to choose a carer to be involved in your care.

Smoking

Smoking is actively discouraged, particularly prior to and immediately post operatively, as this can add to complications of surgery. Yeovil District Hospital has a no smoking policy with which we request your co-operation. You may find it helpful to discuss giving up smoking with your doctor or practice nurse. Nicotine replacement therapy (patches or gum) may be considered, ideally four weeks prior to your admission to the hospital.

Dietary requirements

You will have a choice of meals to select from. If you have special dietary needs please inform a member of staff. Please feel free to remind the ward staff of your needs on your arrival.

Mobile phones

For the safety of all patients the use of MOBILE PHONES is restricted in some areas of the hospital and you may not be able to use your phone on the ward on which you are placed. Please ask the nurse in charge BEFORE you make a call.

Risk management

Yeovil District Hospital has comprehensive Risk Assessment Policies in place, which ensure that patients safety is assured and that areas of improvement are identified and an improvement plan implemented.

Manual handling policy

Yeovil District Hospital operates a Non Lifting Policy. Staff are available to assist your mobility needs and are trained in the use of equipment when it is required. Please ask if you need assistance to move.

Single-sex accommodation

Being in mixed-sex hospital accommodation can be difficult for some patients for a variety of personal and cultural reasons. Here at Yeovil District Hospital we understand this and strive to treat all patients in privacy and with dignity. For this reason, we have worked to ensure that we provide single-sex accommodation for all patients where ever possible. Privacy and dignity are at the heart of our policy and they are vital components of quality care. The over-arching goal is to deliver single-sex accommodation across the service, however the varied needs of different patient groups and clinical settings are recognised. There are occasions when mixed-sex accommodation is unavoidable, but patients’ privacy and dignity will always be assured.

What to pack and bring into hospital

Pack a small bag of clothes and other items (see check list below).

Please bring with you any medication that you are taking in the original containers. There is very limited storage space on the ward so please bring your belongings in a soft sided holdall in preference to a suitcase.

  • Your Knee Replacement Guidebook
  • Footwear: Slippers – not mules. Trainers/flat shoes, preferably slip on
  • Aids: Walking sticks or frame, crutches, dressing aid
  • Nightwear: Dressing gown, nightdress/pyjamas
  • Daywear: Loose fitting day clothes
  • Toiletries and towels. Tissues and wet wipes
  • Money: Small amount for newspapers, magazines. Please do not bring credit or debit cards with you
  • Books/magazines

Contact between patients and their relatives and friends

Visiting times are 10am to 9pm daily. These may be extended for compassionate reasons, or restricted if this is appropriate for the patient’s needs.

  • If your relatives have a problem visiting within these times, please ask one of the nurses who will make arrangements to suit both needs.
  • Please ask your relatives to show respect and consideration towards patients and staff whilst they are visiting.
  • You may become tired and need to rest. Please remember that other patients may wish to rest or sleep during visiting hours.
  • A patient should have no more than two visitors per bed at any time.
  • Visitors are reminded to use the hand gel provided on entry and exit to the ward to prevent cross infection.
  • Visitors must not sit on the patient’s bed at any time, please use the chairs provided and return them to the appropriate place.
  • Please nominate one family member to liaise with the ward for patient information as this releases the nurses to care for your relative more effectively.
  • Relatives can call the ward 01935 384322.
  • Mobile phones can be used on the ward. However, please respect other patients when using your phone. Mobile phones are brought into hospital at your own risk.
  • Free Wi-Fi is also available throughout the hospital for patient use.
  • Due to the high volume of electrical devices no fresh cut flowers are to be brought onto the ward.

Total knee replacement

The normal knee The knee joint has three parts: your thigh bone (the femur), shin bone (the tibia) and knee cap (the patella). This type of joint is called a hinge joint because your knee joint moves in a similar way to a hinge on a door. The surfaces of the joint are covered by articular cartilage, which is a firm slippery material about 3mm thick. A small amount of lubricating fluid is present and aids movement. This allows painless and effortless movement of the joint even under a load. The knee has four ligaments which hold the joint together and prevent unstable movement. They are tough fibrous bands attached at each end to the bone. Although the knee appears to act as a hinge, it can rotate and stretch in smaller amounts as well.

Knee function

The knee takes your body weight and it must cope with walking, running, crouching, bending and lifting objects. To do this it has powerful muscles and a large range of movement. The two most important muscle groups are the quadriceps and the hamstrings. The quadriceps is a big muscle group of the front of the thigh. It straightens the knee. The hamstrings are at the back of the thigh and they bend the knee. These muscles control knee movement and are vital for the stability of the joint.

When the knee becomes arthritic

As we get older many people will develop “wear and tear” arthritis of the knee, although some will have rheumatoid arthritis which also involves other joints. Many factors may contribute to having arthritis; obesity, accidents, vigorous sport or a family history may all play a part. In osteoarthritis (wear and tear), certain changes occur in the joint. The smooth cartilage becomes flaky and develops small cracks. The bone underneath the cartilage becomes denser. The lining of the joint becomes inflamed and may thicken up. As the arthritis progresses, there may be: Severe wear of the cartilage allowing the bones to rub and grate together.  Loss of the joint space. Formation of bony lumps called osteophytes. Swelling of the knee. Knock-knee or bow leg.

These changes may result in PAIN, LOSS OF MOVEMENT and LOSS OF MUSCLE POWER.

The artificial joint

The artificial knee joint closely follows the shape of the real joint. It has been designed and tested to replicate the function of the normal knee. There are many designs of artificial knee joint. Your surgeon will choose the most suitable for you. There are various types of knee replacement. A total knee replacement resurfaces the whole of your knee. This is the most common operation as more than one area of the knee is usually damaged.

A partial knee replacement resurfaces either the inner or outer half of the knee or the joint between the thigh bone and knee cap. Partial knee replacements only work for those patients with arthritis in one part of the knee. They are not an option if you have inflammatory disease such as rheumatoid arthritis, if the damaged area is more extensive, or if your knee has become very stiff. The combination of metal and plastic means the joint has low friction, wears very slowly and moves easily with your weight on it. Remember, only small slithers of bone damaged by arthritis are removed, not the whole knee.  

Why do I need a knee replacement?

You should consider a knee replacement if:

  • You have constant pain despite taking painkillers.
  • You are unable to do everyday things and so are less independent
  • You cannot walk very far now and may have to use a stick. Stairs can be very difficult.
  • Your knee is getting stiff and you cannot bend it easily.
  • You are unable to work because of your painful knee.

 The Operation

A knee replacement is a major operation. You will spend 3 – 4 hours in the operating department. The operation itself will take 1 – 2 hours. During a total knee replacement operation:

  • The worn surfaces at the bottom end of the thigh bone (femur) and the top end of the shin bone (tibia) are removed.
  • The surfaces are covered with metal implants fixed in place with bone cement.
  • A smooth plastic insert is fixed to the top of the tibial implant. This ensures that the two surfaces glide smoothly together.
  • Sometimes the underside of the knee cap (patella) is also re-surfaced with plastic.
  • The layers of soft tissue, muscle and skin are repaired and stitched back together.

Partial knee replacement surgery will be slightly different depending on the part of the knee to be replaced.

You should be prepared to work hard at the exercises given to you by the therapy staff.

Most patients tell us that they are pleased with the result of their knee replacement. Some, however, are less satisfied either because a complication has arisen or their expectations are too high.