I don’t think it will surprise anyone who’s met me or read my blog that  in my opinion surgery is to be considered the last resort, the thing you do when you’ve tried everything else or things have got so bad there just isn’t another option. But if you are at that point then I think it’s important to get the BEST results possible.

These points apply for all kind of knee surgery – Total Knee Replacement (TKR), Arthroscopy and Anterior and Posterior Cruciate Ligament Repair.

Get a thorough, physical assessment!

This MUST include getting your hips, ankles and other knee checked properly as well. All of these joints work together and refer pain to each other. So you must be properly assessed to know if you are operating and treating the right joint to actually solve the problem.

Check your options

Arthroscopies are only as effective as placebo and 34% of knee replacements might be “inappropriate”. So do your research, get a second opinion. Surgery might not be the only option, it might just be the only option your doctor can offer you.

Get the knee in good shape

A knee replacement only replaces the bone not the soft tissue around it. So if the soft tissue is in bad shape before surgery, it’s only going to get worse! This study shows that pre-operative rehabilitation led to significantly improved results.

The following conditions must be met BEFORE surgery to ensure a good outcome:

• Full range of motion – that’s completely straight as well as completely bent
• Little or no swelling
• Normal walking (no limp!)
• Good quad strength

Getting the knee straight is far more important that getting it bent – you can do these basic exercises but the best thing ever is my Elite Seat (I’ll bore you with that another day!)

Prepare for post-surgery

You will most likely need at least 1, if not 2 crutches to get home. These aren’t always provided, so get them before you go and PRACTICE!

Have an ice pack or two ready to help to reduce swelling.

Start your knee straightening exercises as soon as possible, preferably within 24 hours of surgery! (do check with your physio in case of any complications)

Also do bear in mind that a “successful” surgery from your surgeon’s point of view doesn’t always mean the pain goes away. In fact recent evidence suggest as many as 20% of total knee replacement patients continue to suffer chronic pain after surgery.